تأثیر ویتامین D بر مقاومت به انسولین در بیماران دیابتی نوع دو: مدل هم‌گروهی جامع

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه اپیدمیولوژی و آمارزیستی، دانشکده‌ی بهداشت و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه اپیدمیولوژی و آمارزیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، مرکز توسعه‌ی تحقیقات بالینی، دانشگاه علوم پزشکی قم، قم، ایران

چکیده

مقدمه: شماری از مطالعات مشاهده‌ای نشان داده‌اند که مصرف ویتامینD یکی از اقدامات پیشگیرانه‌ای است که نقش بالقوه‌ای در کاهش پیشرفت دیابت نوع 2، مقاومت به انسولین و سندرم متابولیک دارد. هدف این مطالعه، بررسی تأثیر ویتامین D بر مقاومت به انسولین در بیماران مبتلا به دیابت نوع دو در شهر قم بود.روش‌ها: مطالعه در قالب مدل هم‌گروهی جامع در سال 1391 در شهر قم انجام شد. شرکت‌کنندگان120بیمار دیابتی بودند که 58 نفر از آن‌ها موافقت کردند که به طور تصادفی در دو گروه قرار بگیرند و 62 بیمار طبق ترجیح خود در دو گروه دیگر قرار گرفتند. برای گروه درمان در گروه‌های تصادفی‌شده و ترجیحی، یک عدد قرص ویتامین D 50000 واحدی خوراکی هر هفته یک عدد برای مدت 3 ماه استفاده شد. در گروه شاهد یک عدد قرص دارونمای ویتامین D، مشابه روش توضیح داده‌شده در بالا، داده شد. در گروه ترجیحی، بیماران نه ویتامین دریافت کردند و نه دارونما. وجود مقاومت به انسولین به صورت HOMA-IR (Homeostatic model assessment: insulin resistance) بیشتر از 87/3 تعریف شد.یافته‌ها: پس از کنترل متغیر‌های جنس، سن، شاخص توده‌ی بدنی، دور کمر، مدت ابتلا به دیابت، بیماری قلبی و نمایه‌ی HOMA-IR، نتایج این مطالعه نشان داد که ویتامین D در گروه تصادفی‌شده به طور معنی‌داری باعث کاهش نمایه‌ی HOMA-IR گردید، اما در گروه ترجیحی (هم‌گروهی) این کاهش از نظر آماری معنی‌دار نبود.نتیجه‌گیری: ویتامین D می‌تواند بر کاهش سطح قند خون ناشتا و مقاومت انسولین در گروه تصادفی‌شده مؤثر باشد اما در گروه ترجیحی قادر به این کاهش نیست.

کلیدواژه‌ها

عنوان مقاله [English]

Impact of Vitamin D on Insulin Resistance in Patients with Type ΙΙ Diabetes: A Comprehensive Cohort Design

نویسندگان [English]

  • Mostafa Vahedian 1
  • Mohammad Reza Maracy 2
  • Mahmood Parham 3
1 MSc Student, Department of Epidemiology and Biostatistics, School of Health AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Clinical Development Research Center, Qom University of Medical Sciences, Qom, Iran
چکیده [English]

Background: Some observational studies show that the consumption of vitamin D is one of the preventive methods which may potentially be useful in the reduction of diabetes type ΙΙ development, insulin resistance, impaired glucose tolerance, and metabolic syndrome. The purpose of this study was to evaluate the effect of vitamin D on insulin resistance in patients with type II diabetes.Methods: This study was conducted as a comprehensive cohort design in Qom, Iran, in 2012. The participants were 120 patients with type II diabetes of whom, 58 agreed to be randomized into two groups and 62 patients were allocated to their preferences. For randomized treatment group, a pill of vitamin D which contained 50000 units was used weekly and orally for duration of 3 months. In the control group, the placebo pill of vitamin D was prescribed by the same method. In the preferential group, patients received neither vitamin D nor placebo. The value of insulin resistance was defined as a score greater than 3.87 in HOMA-IR (Homeostatic model assessment -estimated insulin resistance) index.Findings: Vitamin D could significantly decrease the HOMA-IR index in the randomized group after controlling for the variables of sex, age, body mass index (BMI), waist, duration of diabetes, heart disease, and HOMA-IR index at the beginning of the study. The reduction was not statistically significant in the preferential group.Conclusion: Vitamin D can affect the reduction of fasting blood sugar (FBS) and insulin resistance in the randomized group but in the preferential group it cannot.

کلیدواژه‌ها [English]

  • Vitamin D
  • Insulin Resistance
  • Type ΙΙ diabetes
  • Comprehensive cohort design

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مجله دانشکده پزشکی اصفهان
دوره 31، شماره 239 - شماره پیاپی 239
مرداد و شهریور 1392
صفحه 777-791

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سابقه مقاله

  • تاریخ دریافت: 19 دی 1391
  • تاریخ بازنگری: 07 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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