Abstract

Objective To study the change of vitamin D in newly diagnosed type 2 diabetes mellitus (T2DM), and to explore the relationship between the level of serum vitamin D and islet β cell dysfunction as well as insulin resistance. Methods Fasting serum 25-hydroxyvitamin D3 (25-(OH)D3) concentration was measured by high pressure liquid chromatography (HPLC) in 97 newly diagnosed T2DM patients (men 57, women 40, aged (52±10)years) and 69 healthy controls (men 40, women 29, aged (50±11)years). Oral-glucose-tolerance test was performed, and area under the curve of glucose (AUCG), area under the curve of insulin (AUCI), early-phase insulin secretion index (ΔI30/ΔG30), β cell function index (HOMA-B), insulin resistance index (HOMA-IR) were compared between T2DM with low 25-(OH)D3 ((25-(OH)D3 <37.5 nmol/L, n=61) and those without (n=36). The correlation of serum 25-(OH)D3 with sex, age, body mass index (BMI), waist-hip rate (WHR), blood pressure, lipids, HbA1c, insulin resistance and β cell function was analysed by using Pearson correlation and multiple stepwise regression analysis. Results The level of serum 25-(OH)D3 was much lower in T2DM patients than in controls ((36±19)nmol/L vs (80±26) nmol/L, t=-13.00, P<0.01). The prevelence of hypovitaminosis 25-(OH)D3 in T2DM was 62.9% (61/97). Among T2DM, when compared with those without hypovitaminosis 25-(OH)D3, patients with hypovitaminosis 25-(OH)D3 showed higher HbA1c and AUCG ((10.1±3.0)% vs (7.7±2.6)%, (32±7) h·mmol-1·L-1vs (25±7) h·mmol-1·L-1,t values were 4.44 or 4.45, both P<0.01), although HOMA-B, ΔI30/ΔG30, and AUCI were significantly lower (21±16 vs 75±64, 1.9±1.9 vs 8.3±7.7, (30±21) h·mU-1·L-1vs(104±80) h·mU-1·L-1,t values were -5.68, -6.81, and -7.69; all P<0.01). In multiple stepwise regression analysis, ΔI30/ΔG30 and AUCI had independent positive correlation with 25-(OH)D3 (t values were 2.21 and 4.67, all P<0.01). Conclusion 25-(OH)D3 is lower in newly diagnosed T2DM, and associated with severity of blood glucose disorders. The shortage of vitamin D in T2DM may be correlated with decreased early-phase insulin secretion and whole insulin secretion. Key words: Diabetes mellitus, type 2; Calcifediol; Insulin

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