目的 给予葡萄糖调节受损患者小剂量维生素D治疗,明确维生素D对糖代谢的干预作用.方法 选择196例接受口服葡萄糖耐量试验(OGTT)的受试者,其中葡萄糖耐量正常者67例(糖耐量正常组)、葡萄糖调节受损者129例(葡萄糖调节受损组),进一步将葡萄糖调节受损组分为维生素D干预组(n=64)和未干预组(n=65),维生素D干预组予以小剂量维生素D(400 IU/日)治疗,共1年.治疗前后收集上述受试者的临床资料并检测相关生化指标,明确小剂量维生素D对葡萄糖调节受损患者的干预作用.结果 葡萄糖调节受损组血清25(OH)D3水平显著低于糖耐量正常组.经过为期1年的小剂量维生素D治疗后,与未干预组相比,维生素D干预组患者胰岛素敏感性增加,胰岛素抵抗减轻;维生素D干预组转归为糖尿病的患者比例(39.1%)低于未干预组(46.2%),但两组间差异无统计学意义(P>0.05).结论 维生素D干预治疗可改善葡萄糖调节受损患者的胰岛素敏感性,减轻胰岛素抵抗.小剂量维生素D有一定改善葡萄糖调节受损患者异常糖代谢结局的作用.
Objective To explore the intervention effect of low-dose vitamin D on glucose metabolism of patients with impaired glucose regulation. Methods A total of196 subjects receiving oral glucose tolerance test were enrolled in this study, including individuals with normal glucose tolerance ( NGT group, n=67) and indi-viduals with impaired glucose regulation (IGR group, n=129). The IGR group was divided into intervention group ( n=64) and non-intervention group ( n=65) according to vitamin D intervention ( for 1 year) performed or not. Clinical data and biochemical parameters were collected. Results The level of serum 25(OH)D3 was significantly lower in the IGR group than that of normal control group ( P<0. 05) . After 1 year of low-dose vita-min D intervention, insulin sensitivity increased and insulin resistance decreased in the intervention group as compared with non-intervention group. Diabetes developed less frequently in the intervention group ( 25 of 64 [ 39. 1%] ) compared with non-intervention group ( 30 of 65 [ 46. 2%] ) . But there was no significant differ-ent in diabetes prevalence between the two groups. Conclusions Vitamin D intervention can improve insulin sensitivity and reduce insulin resistance in patients with impaired glucose regulation. Low dose vitamin D can improve the abnormal glucose metabolism outcome in patients with impaired glucose regulation.