Zastupljenost deficita vitamina D3 kod bolesnika sa dijabetesom melitusom tip 2 i proteinurijom
Sažetak
Uvod/Cilj. Vitamin D3 ima važnu ulogu u metabolizmu glukoze, a ispoljava se kroz uticaj na insulinsku sekreciju i senzitivnost. Upala niskog stepena je prisutna kod bolesnika sa dijabetesom tip 2, a poznato je da vitamin D3 ima značajno antiinflamatorno dejstvo. Nedostatak vitamina D3 je posebno izražen kod bolesnika sa dijabetesnom nefropatijom. Nivo vitamina D3 je tokom godine uslovljen sezonskim promenama, prvenstveno uticajem UV zračenja. Cilj rada je bio da se utvrdi prevalencija deficita vitamina D3 kod bolesnika sa dijabetesnom nefropatijom. Metode. Ispitanici sa dijabetesom tipa 2 i dijabetesnom nefropatijom su uključeni u studiju nakon određivanja vrednosti vitamina D3. Rezultati su klasifikovani kao normalni ili sniženi, u odnosu na donju granicu normalnih vrednosti koja je data za svaki mesec u godini. Za potrebe daljeg istraživanja bolesnici sa sniženim nivoom vitamina D3 podeljeni su u dve grupe: studijsku i kontrolnu grupu, svaka sa po 45 bolesnika. Studijska grupa ispitanika je dobijala holekalciferol u dozi potrebnoj za postizanje planiranog optimalnog nivoa vitamina D3 od 90–100 nmol/L u krvi. Rezultati. Vrednost vitamina D3 kod svih ispitanika sa deficitom vitamina D3 (n = 90) na početku istraživanja je iznosila 45,1 ± 15,6 nmol/L. Zastupljenost bolesnika sa deficitom vitamina D3 je u ispitivanom uzorku (n = 109) bila 82,56%, dok su normalne vrednosti vitamina D3 imalo 17,43% ispitanika. Utvrđena je statistički značajna razlika u odstupanju nivoa vitamina D3 od donjih normalnih vrednosti između zimskog i letnjeg perioda u celoj grupi ispitanika, pri čemu je odstupanje bilo izraženije u letnjem periodu. Nije utvrđena razlika tih vrednosti između muškaraca i žena, mada je kod oba pola odstupanje bilo izraženije u letnjem periodu. Zaključak. Deficit vitamina D3 je značajno zastupljen kod bolesnika sa dijabetesnom nefropatijom.
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