Vitamin D affects insulin sensitivity and β-cell function in obese non-diabetic youths
Vitamin D affects insulin sensitivity and β-cell function in obese non-diabetic youths
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维生素D影响肥胖非糖尿病青年的胰岛素敏感性和β细胞功能
DOI：
10.1530/eje-19-0369
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发表时间：
2019-10-01
影响因子：
5.8
通讯作者：
Maffeis, Claudio
中科院分区：
文献类型：
--
作者：
Corica, Domenico;Zusi, Chiara;Maffeis, Claudio
目的：维生素D可能在葡萄糖稳态和ii细胞功能（BCF）中发挥潜在的核心作用，尽管研究并不一致。本研究的目的是验证超重和肥胖非糖尿病儿童维生素D、胰岛素敏感性（IS）和BCF之间存在直接关系的假设。设计与方法：横断面研究在维罗纳大学医院儿童肥胖门诊进行。122名白种人超重和肥胖儿童（年龄：12.8±0.2岁）被纳入研究。排除标准：遗传或内分泌原因导致的肥胖、慢性疾病或治疗。患者行口服葡萄糖耐量试验。计算HOMA-IR、Matsuda指数和胰岛素生成指数。通过数学建模对BCF进行重构，并采用导数控制和比例控制对BCF进行描述。测定总25-羟基维生素D和维生素D结合蛋白（VDBP）。研究VDBP基因的两个snp (rs4588和rs7041)，计算生物利用度维生素D （BVD）。结果：90%的患者存在维生素D缺乏症。47名受试者的两个snp均为纯合子。总维生素D与Matsuda指数（P = 0.002）、VDBP （P = 0.045）呈正相关，与BMI SDS （P = 0.043）、HOMA-IR （P = 0.008）、HOMA-B （P = 0.001）、IGI （P = 0.007）、衍生对照（P = 0.036）、比例对照（P = 0.018）呈负相关。经年龄、性别、BMI SDS、青春期和维生素D测量的季节性调整后，总维生素D是松田指数、HOMA-IR、HOMA-B、IGI、比例控制的预测因子（均P < 0.05）。BVD与总维生素D呈正相关（P < 0.001），与BMI SDS呈负相关（P = 0.041）。结论：维生素D缺乏症对BCF和IS有负面影响，提示维生素D水平可能与超重和肥胖个体的糖代谢障碍有关。
Objective: Vitamin D may potentially play a central role in glucose homeostasis and II-cell function (BCF), although studies are not consistent. Aim of our study was to test the hypotheses of a direct relationship between vitamin D, insulin sensitivity (IS) and BCF in overweight and obese non-diabetic children.Design and methods: Cross-sectional study carried out at the Childhood Obesity Outpatient Clinic, University Hospital of Verona. One hundred twenty-two Caucasian overweight and obese children (age: 12.8 +/- 0.2 years) were enrolled. Exclusion criteria: genetic or endocrine causes of obesity, chronic diseases or therapies. Patients underwent oral glucose tolerance test. HOMA-IR, Matsuda index and insulinogenic index were calculated. BCF was reconstructed by mathematical modeling and described by Derivative and Proportional Control. Total 25-hydroxyvitamin D and vitamin D-binding protein (VDBP) were measured. Two SNPs (rs4588 and rs7041) in the VDBP gene were studied, and bioavailable vitamin D (BVD) was calculated.Results: Hypovitaminosis D was documented in 90% of patients. Forty-seven subjects were homozygous for both SNPs. Total vitamin D was positively correlated with Matsuda index (P = 0.002), VDBP (P = 0.045), and negatively with BMI SDS (P = 0.043), HOMA-IR (P = 0.008), HOMA-B (P = 0.001), IGI (P = 0.007), derivative control (P = 0.036) and proportional control (P = 0.018). Total vitamin D, adjusted for age, gender, BMI SDS, puberty and seasonality of vitamin D measurement, was a predictor of Matsuda index, HOMA-IR, HOMA-B, IGI, proportional control (all P < 0.05). BVD was positively correlated with total vitamin D (P < 0.001) and negatively with BMI SDS (P = 0.041).Conclusions: Hypovitaminosis D negatively influences BCF and IS, suggesting that vitamin D levels might be implicated in glucose metabolism impairment in overweight and obese individuals.