Relación entre hemogloblina glucosilada y concentraciones séricas de vitamina D
Resumen
Antecedentes: la vitamina D participa en la sensibilidad a la insulina mediante el metabolismo del calcio y regula la expresión del gen del receptor de la insulina. Diversos estudios muestran la relación entre deficiencia de vitamina D e intolerancia a la glucosa, con disminución en la secreción de insulina.
Objetivo: determinar la relación entre las concentraciones séricas de vitamina D y hemoglobina glucosilada en pacientes con diabetes tipo 2.
Material y métodos: se seleccionaron pacientes con diabetes tipo 2 adscritos a la consulta externa de Medicina Interna del Hospital General Ticomán. Se determinaron las concentraciones séricas de 25-hidroxivitamina D, hemoglobina glucosilada, calcio y fosforo, BUN, creatinina y glucosa preprandial.
Resultados: se registaron 60 pacientes (30 casos y 30 controles): 37 (61.7%) mujeres y 23 (38.3%) hombres, con promedio de edad de 46.8±12.01 años. Los pacientes con diabetes tuvieron media de vitamina D sérica de 12.68±6.7 ng/dL y hemoglobina glucosilada de 11.33±2.43%. El coeficiente de correlación de Pearson para vitamina D sérica y hemoglobina glucosilada mostró valores de r=-0.738, con coeficiente de determinación r2 de 0.545 (55%) p <0.0001; RM=91 (IC 95%, 15.4-529.4) y X2=38.5, p< 0.0001.
Conclusiones: existe relación estadísticamente significativa entre hipovitaminosis D y diabetes tipo 2, con valor de X2 de 38.5 p< 0.0001. La RM=91 (IC 95%, 15.4-529.4) sugiere que la hipovitaminosis D representa un riesgo 91 veces mayor de diabetes tipo 2.
Palabras clave: vitamina D, hemoglobina glucosilada, diabetes mellitus tipo 2.
Abstract
Background: Vitamin D is involved in insulin sensitivity by calcium metabolism and regulating gene expression insulin receptor. Several studies show a correlation between vitamin D deficiency and glucose intolerance, a decrease in insulin secretion.
Objective: To determine the relationship between serum vitamin D levels and glycosylated hemoglobin in patients with diabetes mellitus type 2 (DM2).
Material and methods: Patients with type 2 diabetes assigned to the outpatient clinic of Internal Medicine, General Hospital Ticomán and without DM2 patients were recruited. They were measured: serum 25-hidroxivitamin D, glycated hemoglobin, serum calcium and phosphorus, BUN, creatinine, and serum glucose preprandial.
Results: 60 patients, 30 cases and 30 controls, 37 women (62.8%) and 23 (38.3%) men were included. Mean age 46.8±12.01 years. In the group with DM2: vitamin D levels had a mean of 12.68±6.7 ng/ dL. Glycosylated hemoglobin with an average of 11.33±2.43%. The Pearson correlation coefficient for serum vitamin D and glycosylated hemoglobin was r=-0738, with a coefficient of determination r2 of 0.545 (55%), p <0.0001. OR=91 (CI 95%, 15.4-529.4); X2=38.5, p <0.0001.
Conclusions: There was statistically significant association between vitamin D levels and DM2 with a value of X2=38.5, p <0.0001. The OR of 91 (CI 95%, 15.4-529.4) translates the presence of vitamin D deficiency confers a risk 91 times greater of DM2.
Keywords: Vitamin D serum, glycated hemoglobin, diabetes mellitus type 2.
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