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Serum 25-hydroxy Vitamin D Level in Diabetic Patients and Its Effect on Blood Glucose and Bone Mass

Author: XuGuiPing
Tutor: YuMingXiang
School: Fudan University
Course: Internal Medicine
Keywords: Diabetic Vitamin Blood glucose levels Metabolic syndrome Bone density Bone mass Calcium intake Femoral neck Lumbar Abnormal glucose metabolism Urinary albumin Dietary calcium Calcium-phosphorus product Bone metabolic markers Osteoporosis Hypertension Bone metabolic disorders Diabetic nephropathy Renal dysfunction Insulin Resistance
CLC: R587.1
Type: Master's thesis
Year: 2011
Downloads: 178
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Abstract


Objective: This study by observing the blood of patients with diabetes 25 - hydroxy vitamin D levels and metabolic syndrome, glucose metabolism and kidney function indicators and quantitative measurement of diabetes in patients with lumbar spine and femoral neck by means of dual-energy X-ray absorptiometry absorptiometry aims to analyze the of diabetes serum 25 - hydroxyvitamin D levels change and the relationship between the metabolic syndrome, glucose metabolism, renal function, and bone mineral density, clinical prevention and treatment of diabetes in patients with osteoporosis and low vitamin D levels new basis. Analysis of diabetic patients and healthy people daily dietary calcium intake, and diabetes by observing the healthy control group respondents daily dietary calcium intake of new clinical evidence for clinical prevention and treatment of calcium deficiency. Subjects and Methods: We collected 2009.10 to 2011.3 Endocrinology, Zhongshan Hospital, Fudan hospitalized diabetic patients 775 cases, exclude not detected blood 25 (OH) D were 94 cases of the remaining 681 patients were analyzed; from Zhongshan hospital health counseling examination center a healthy crowd of 100 cases were randomly selected control group as calcium survey. Data collection time deadline in March 2011. 1. Observation diabetes blood 25 (OH) D levels and gender distribution analysis diabetics blood 25 (OH) D level and age, waist circumference, BMI, hypertension, blood lipids, blood sugar, kidney function and bone metabolism indicators related sex. 2. Analysis of vitamin D deficiency in diabetics group than in the vitamin D deficient group occur odds ratio of metabolic syndrome and its components, analysis of blood 25 (OH) D metabolic syndrome. Observed that lack of vitamin D group lack of vitamin D non-group FPG, HbA1C, FINS, HOMA-IR and HOMA-B differences, analysis of blood 25 (OH) D on glucose metabolism in diabetic patients. Group a lack of vitamin D non-group SCr, BUN, 24h urine microalbumin and eGFR differences, analysis of blood 25 (OH) D renal vitamin D deficiency observed in patients with diabetes. 5 observed vitamin D deficiency in diabetic patients group with vitamin D non-deficient group PTH, calcium-phosphorus product, Total BMD values ??of the ALP and lumbar spine, femoral neck Neck BMD values, femoral neck the differences of Total BMD values, analysis of blood 25 (OH) D impact on bone metabolism. 6. Observe the daily calcium intake (dietary calcium oral the elements calcium content) of the diabetic patients and healthy control group, analysis of diabetes calcium. Results: 1.681 cases of diabetes in patients with an average age (58.60 ± 14.20) years of age, vitamin D deficiency accounted for 76.51%; overall blood 25 (OH) D (38.14 ± 17.37) nmol / L, the average male (40.94 ± 17.34) nmol / L women average (34.58 ± 16.73) nmol / L, men's and women there is a statistically significant difference. Overall diabetes blood 25 (OH) D levels and TG (r = -0.147), HDL (r = -0.088), eGFR (r = -0.104), PTH (r = -0.143), calcium-phosphorus product (r = -0.081) showed a weak negative correlation; waist circumference (r = 0.088), Lg (SCr) (r = 0.160), BUN (r = 0.082), lumbar spine and femoral neck BMD (lumbar Total r = 0.096, femoral neck Neck r = 0.085, femoral neck Total r = -0.123) showed a weak positive correlation; P values ??lt; 0.05; blood 25 (OH) D with age, BMI, TC, LDL, FPG, HbA1C, Lg (FINS) Lg (HOMA-IR), Lg (HOMA-B), Lg (24h urine albumin), ALP and other indicators showed no linear correlation. Vitamin D deficiency in diabetics than vitamin D normal obesity OR = 0.852, the occurrence of hypertension, OR = 1.147, the occurrence of high TG hyperlipidemia OR = 1.325, the occurrence of low HDL hyperlipidemia OR = 1.173, metabolic syndrome OR = 1.138, P values ??were no statistically significant. Vitamin D deficiency group Lg (FINS) than non-lack of vitamin D group (1.02 ± 0.40 VS 0.94 ± 0.38), Lg (HOMA-IR) higher than the vitamin D non-deficient group (0.63 ± 0.46 VS 0.48 ± 0.41), , P lt; 0.05; FBS, HbA1C and Lg (HOMA-B) between the two groups no significant differences. 4. Vitamin D deficiency group with vitamin D non-deficient group in SCr, BUN, of 24h urinary micro albumin and eGFR were no statistical differences (P 'are corrected gt; 0.05). 5. Vitamin D deficiency group PTH group (36.52 ± 17.51pg/mL VS 32.46 ± 13.91 pg / mL) than non-lack of vitamin D; lumbar Total BMD values ??(0.937 ± 0.132 g/cm2 VS 0.978 ± 0.157 g/cm2), femoral neck Neck BMD values ??(0.746 ± 0.119 g/cm2 VS 0.783 ± 0.112 g/cm2), femoral neck Total BMD value of 0.873 ± 0.123 g/cm2 VS 0.916 ± 0.136 g/cm2) were lower than the vitamin D non-deficient group, P P 'lt; 0.05; between the two groups of calcium-phosphate product, ALP was no significant difference. Diabetics average daily dietary calcium intake (727.64 ± 373.20) mg / d, the healthy control group (673.64 ± 276.24) mg / d, two groups of dietary calcium were lower than the Chinese Nutrition Society recommended levels (800mg / d), the difference between the two groups was not statistically significant (P gt; 0.05). Conclusion: 1 diabetes patients the prevalence of vitamin D deficiency and more severe in women than in men; dietary calcium intake of the diabetic group and the healthy control group were lower than the Chinese Nutrition Society recommended levels between the two groups was not statistically significant, the diabetic population common calcium intake in the healthy population. 2 diabetes blood 25 (OH) D and of TG, HDL, eGFR, PTH, calcium-phosphorus product showed a negative correlation; showed a positive correlation with waist circumference, SCr, BUN, lumbar spine and femoral neck BMD. 3. Diabetes patients with vitamin D deficiency group than vitamin D lack the group Lg (FINS), Lg (HOMA-IR) higher; PTH increased lumbar spine BMD and femoral neck were lower.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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