The Effect of Vitamin D on Insulin Resistance and Dyslipidemia of Patients with Peritoneal Dialysis
|Keywords||Peritoneal dialysis vitamin D 25(OH)D insulin resistance dyslipidemia|
Objective:To observe the level of 25 hydroxyl-vitamin D(25(OH)D) of Patients with peritoneal dialysis and the correlation between 25(OH)D and HOMA-IR to analysis the effect of 25(OH)D on insulin resistance of patients with peritoneal dialysis;Observe the relation between 25(OH)D and triglyceride(TG)、total cholesterol(CHOL).To demonstrate the relation between 25(OH)D and dyslipidemia of patients with peritoneal dialysis.Methods:Fifty Patients who undergone Peritoneal dialysis for more than three months and twenty-one healthy persons were selected and diabetes、received vitamin D or analogues or lipid-lowering drugs、acute infections、serious heart failure and trauma were excluded. 25(OH)D were measured by enzyme-linkd immunosorbent assay(ELISA) as a index of vitamin D state. Glycosylated hemoglobin(HBA1C)、fasting plasma insulin(Fins)、fasting plasma glucose(FPG)、total cholesterol(CHOL)、triglycerides(TG)、low density lipoprotein (LDL)、serum albumin(ALB)、serum creatinine(Scr)、serum phosphate(P)、parathyroid hormone(PTH) were measured during the corresponding time.Insulin resistance was evaluated by the homeostasis model assessment method (HOMA).Vitamin D deficiency was defined if 25(OH)D level are less or equal to 50nmol/L.Compare the level of 25(OH)D between peritoneal dialysis and health group,and analysis the effect of Vitamin D level on insulin resistance and dyslipidemia.Result:1. 25(OH)D level of peritoneal dialysis group was obviously lower than that of health group(P<0.01), HOMA-IR、Fins of Peritoneal dialysis group was obviously higher than that of health group(P<0.01). 25(OH)D level was negatively correlated with HOMA-IR、HbA1C、Fins(P<0.01).The level of HOMA-IR、HbA1C、Fins in group A were significantly higher than that of group B(P<0.01). 2.The TG、VLDL which represent dyslipidemia in peritoneal dialysis group were significantly higher than that of health group,HDL in peritoneal dialysis group were significantly lower than that of health group(P<0.01). 25(OH)D level was obviously positively correlated with HDL,was obviously negatively correlated with VLDL(P<0.01), was negatively correlated with TG(P<0.05). The level of TG、VLDL in group A were significantly higher than that of group B(P<0.01).However the level of HDL in group A were significantly lower than that of group B(P<0.01).Conclusion:1. Insulin resistance and hypovitaminoisis D is existed in most patients with peritoneal dialysis.Vitamin D level was compactly correlated with insulin resistance,and significantly affects glycometabolism.2. Dyslipidemia is existed in patients with peritoneal dialysis to some extent.The level of vitamin D is a important factor correlated with dyslipidemia.Whether improve hypovitaminoisis D is a way to regulate glycometabolism and lipid metabolism need to further study.