Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Effects of Vitamin D and Calcium Intervention on the Improvement of Resistance in Patients with Type 2 Diabetes Mellitus

당뇨병환자에서 칼슘과 비타민 D 섭취가 인슐린저항성에 미치는 영향

Choi, Young-Mee;Lee, Jun-Ho;Han, Ji-Sook
최영미;이준호;한지숙

  • Published : 20090800
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Abstract

Background: Recent reports suggest that the intake of vitamin D and calcium may influence insulin resistance. The aim of this study was to assess the effects of vitamin D and calcium intervention on the improvement of blood glucose and insulin resistance in patients with type 2 diabetes mellitus (DM). Methods: Fasting blood glucose, glycosylated hemoglobin A1c (HbA1C), serum 25(OH)D3, serum lipid levels, insulin secretion, and activity and dietary surveys were analyzed in type 2 DM patients both before and after a 12-week vitamin D and calcium intake intervention. Results: The serum 25(OH)D3 level was found to be negatively correlated with insulin resistance and fasting blood glucose. Calcium intake level was also negatively correlated with insulin resistance. Fasting blood glucose, HbA1C, and HOMA-IR decreased significantly (P <0.05) following vitamin D and calcium intake intervention in the medical nutrition therapy (MNT) group, while there was no such change observed in the control group. Dietary calcium and vitamin D intakes were significantly (P <0.05) higher in the MNT group than in the control group. The concentrations of serum 25(OH)D3 and insulin secretion increased slightly in the MNT group following the 12-week intervention; however, these results did not reach statistical significance. Conclusion: The results of the present study indicate that calcium and vitamin D intervention may be helpful in improving fasting blood glucose, HbA1C, serum 25(OH)D3 and HOMA-IR in patients with type 2 DM who have insufficient serum 25(OH)D3 concentrations.

연구배경: 최근의 연구 보고들은 비타민 D와 칼슘의 섭취가 인슐린저항성에 영향을 줄 수 있음을 시사한다. 이 연구의 목적은 제2형 당뇨병환자에서 비타민 D와 칼슘의 중재가 혈당과 인슐린저항성 개선에 미치는 영향을 평가하기위한 것이다. 방법: 12주간의 칼슘과 비타민 D 섭취 중재요법 전 후에 공복혈당, 당화혈색소, 혈청 $25(OH)D_3$, 혈청지질, 인슐린분비량, 활동 시간과 식이 섭취 조사가 분석되었다. 결과: 혈청 $25(OH)D_3$ 농도는 인슐린저항성, 혈당과 부의 관계였다. 칼슘 섭취수준 역시 인슐린저항성과 부의 관계였다. 공복혈당과 당화혈색소, $HOMA_{IR}$은 칼슘${\cdot}$비타민 D 섭취 중재 영양의학요법 후 실험군에서 유의하게(P < 0.05)감소하였고 반면 대조군에서는 변화가 없었다. 식이 칼슘과 식이 비타민 D섭취는 대조군 보다 실험군에서 유의하게(P < 0.05) 높아졌다. 혈청 $25(OH)D_3$와 인슐린 분비는 12주간의 중재 후 실험군에서 약간 높아졌으나 유의하지는 않았다. 결론: 이상의 결과로 혈청 $25(OH)D_3$가 부족한 제2형 당뇨병환자에서 혈당, 당화혈색소, 혈청 $25(OH)D_3$, $HOMA_{IR}$의 개선에는 칼슘${\cdot}$비타민 D 중재 교육이 도움이 될 수 있음을 알 수 있다.

Keywords

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