ภาวะขาดวิตามินดีในคนไข้เบาหวานชนิดที่ 2

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รัชนีพร ชื่นสุวรรณ
สมชาย ยงศิริ
เพ็ชรงาม ไชยวาณิช

บทคัดย่อ

Introduction Current evidence suggests that vitamin D deficiency may contribute to an increased
risk of type 2 DM.
Objective The aim of this study is to explore the relationship between vitamin D status and
type 2 DM.
Material and Methods A cross-sectional study was conducted on 360 patients at the outpatient
diabetes clinic of Burapha University Hospital. Patients were prospectively recruited, physically
examined, submitted to laboratory investigations as well as given a vitamin D level assessment.
Results The mean level of 25(OH)D was 25.0 ± 7.7ng/ml. 26.6% of the patients had vitamin
D deficiency; 48.8% had vitamin D insufficiency. After making adjustments for all variables,
we found that body mass index (BMI) (r = -0.123, p-value = 0.02), waist circumference (WC)
(r = -0.0565, p-value=0.28), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)
(r = -0.006, p-value = 0.91) had an inverted correlation to vitamin D levels. In terms of ALT levels,
about 10.56% of the population had nonalcoholic fatty liver disease (NAFLD). In addition, we
found that diastolic blood pressure (DBP) (r = 0.159, p-value = 0.002) and fasting blood sugar
levels (FBS) (r = 0.127, p-value = 0.016) correlated with the presence of NAFLD. In contrast,
insulin sensitivity (r = -0.186, p-value < 0.001), triglycerides (r = 0.138, p = 0.009), and Time to
DM (r = -0.182, p = 0.001), had inversely correlated with NAFLD.
Conclusion High prevalence of vitamin D deficiency was observed in our diabetic type 2 patients.
After multivarious adjustments for all variables, high WC, high BMI, and high HOMA-IR were
associated with an increased risk of vitamin D deficiency; while high FBS, low insulin sensitivity
and short duration of a type 2 DM were associated with an increased risk of NAFLD.

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