Medine ŞİŞMAN, Betül ERİŞMİŞ, Meral MERT

D vitamini düzeyi insülin direncini etkiler mi?

Amaç: D vitamini, en önemli etkisi kalsiyum, fosfor metabolizması ve kemik mineralizasyonu üzerine olan bir vitamindir. Ancak son yıllarda D vitamininin, malinite, kardiyovasküler hastalıklar, metabolik sendrom, enfeksiyöz ve otoimmün hastalıklar gibi birçok kronik hastalıkla ilişki içinde olduğu tespit edilmiştir. Bu çalışmamızda diyabet ve obeziteye sıklıkla eşlik eden insülin direnci ile D vitamini düzeyi arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntem: 2015-2017 yılları arasında, Bakırköy Dr. Sadi Konuk SUAM poliklinik takipli 302 hastanın kayıtları retrospektif olarak incelendi. Hastaların tiroit uyarıcı hormon, insülin, açlık kan şekeri, hemoglobin A1c, anti tiroglobulin antikoru, anti tiroit peroksidaz antikoru, vitamin B12, folat düzeyleri kaydedildi. Hastalar vitamin D yetersiz grup (vitamin D eksikliği olanlar da dahil) ve vitamin D normal grup şeklinde ikiye ayrıldı. İstatistiksel analizler SPSS 24.0 sürümü ile yapıldı ve anlamlılık düzeyi 0,05 olarak ele alındı.Bulgular: Çalışmaya alınan 302 hastanın 256’sı (%84,7) kadın, 46’sı (%15,2) erkekti. Vitamin D düzeyine göre iki gruba ayrılan hastaların; vitamin D düzeyi ile AKŞ, HOMA-IR, HbA1c ve tiroit immünitesi arasında anlamlı ilişki (p<0,05) saptanırken; cinsiyet, yaş, folat, vitamin B12, TSH arasında anlamlı ilişki saptanmadı (p≥0,05). Korelasyon analizine göre HOMA-IR; HbA1c ile %15,9, tiroit immünitesiyle %8,2 ve AKŞ ile %28 pozitif ilişkili saptandı. HbA1c ise tiroit immünitesiyle ilişkili bulunmazken AKŞ ile %22,1 pozitif ilişkili saptandı.Sonuç: Vitamin D eksikliği, yetersizliği saptanan hastalarda insülin direnci olabileceği de öngörülmelidir. Birinci basamakta metabolik kontrolün sağlanması, insülin direnci ve ilişkili patolojilerin önlenmesinde vitamin D’nin önemine dikkat çekilmelidir.

Anahtar Kelimeler:

vitamin D, diyabet, insülin direnci

Does vitamin D level affect insulin resistance?

Purpose: The most important effect of vitamin D (vit D) is on calcium, phosphorus metabolism and bone mineralization. However, in recent years, vit D deficiency has been found to be associated with many chronic diseases. In this study, we aimed to investigate the relationship between insulin resistance and vit D levels.Patients and methods: The records of 302 patients were evaluated retrospectively. Thyroid stimulating hormone (TSH), insulin, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), anti-thyroglobulin antibody, anti-thyroid peroxidase antibody, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), vitamin B12, folate levels of patients were recorded. Analyzes were made with SPSS version 24.0 and significance level was considered as 0.05.Results: Of the 302 patients, 256 (84.7%) were female and 46 (15.2%) were male. Patients were divided into 2 groups as vitamin D deficiency/insufficiency and normal vitamin D levels. There was a significant correlation between vitamin D levels and FBG, HOMA-IR, HbA1c and thyroid immunity status (p <0.05), but was no significant relationship with sex, age, folate, vitamin B12 and TSH (p≥0.05). HOMA-IR was associated with; HbA1c with a positive correlation of 15.9%, thyroid immunity with a positive correlation of 8.2%, FBG with a positive correlation of 28%. HbA1c was not associated with thyroid immunity but was 22.1% positively associated with FBG.Discussion: Insulin resistance should be predicted in patients with vitamin D deficiency. The importance of vitamin D in providing metabolic control, insulin resistance and related pathologies in primary care should be remembered.

Keywords:

vitamin D, diabetes, insulin resistance,

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