البحث — المستودع الرقمي العراقي

المستخلص: Diabetes Mellitus is a chronic metabolic disorder , caused persistent hyperglycemia resulting from defects in insulin production, insulin action or both.There are several evidence suggest that altered vitamin D and calcium homeostasis may play a role in the development of T2DM and IR .Lipoprotein(a) is a LDL - like particle consisting of Apo A moiety linked to one molecule of ApoB100 . Several studies revealed that Lp(a) may differentially affect in diabetic patient either increase or decrease or no change from normal range . It is not clear whether Lp(a) concentration is related to T2DM or associated with IR .Objectives : The present study was designed to measure vitamin D status and Lp(a) levels among patients with T2DM , to investigate association between serum 25(OH) D levels with IR , lipid profile and some metabolic factors and to demonstrate whether Lp(a) levels are linked to T2 DM. Methods and Materials : The present study included 80 patients with T 2 DM (30 male and 50female) with mean age (50.51± 10.70) year . Weigh, height, BMI were assessed for each participant . Fasting blood samples were collected to measure HbA1c% .Then another part of blood separated to get serum to measure [Vitamin D , Insulin , Lp(a) , FBS , Lipid profile , creatinine , calcium , phosphate] .Insulin resistance , Insulin sensitivity , β - cell function was calculated by homeostatic model assessment ( HOMA - IR) , (HOMA - IS) and (HOMA - %β ) respectively .Results : The result of this study revealed that serum vitamin D among diabetic patients with a mean (19.94 ± 9.59) ng/ml . Frequency of vitamin D deficiency [s.25(OH)D > 20 ng/ml ] was (52.5%) , Only (12.5%) of diabetic patients had normal levels of vitamin D [s.25(OH)D≥ 30 ng /ml] . Thirty five percent of patients with vitamin D insufficiency [s.25(OH)D = 20 - 29.9 ng /ml ] .Vitamin D among diabetic patients of the present study showed an inverse relationship with BMI , HOMA - IR, insulin , HbA1c, TG , VLDL - c, age statistically significant independent , But positive significant independent association with HOMA - IS , HDL - c and statistically significant not independent associated with FBS, HOMA - %β). No significant associated with other biochemical parameters . Regarding to the levels of Lipoprotein (a) levels among diabetic patients found with a mean (7.93± 5.34) mg/dl and no significant association with glycemic profile (FBS,HbA1c, insulin , HOMA - IR, HOMA - IS , HOMA - %β ) or lipid profile .Conclusion : The decline in the level of vitamin D among diabetic subject may affect glucose homeostasis . In addition to that hypovitaminosis D could be rising with increase BMI and obesity among diabetic subjects , BMI is positively associated with insulin resistance . Serum 25(OH)D among diabetic subject is negatively with insulin resistance . Therefore vitamin D deficiency may contribute to onset of IR and development of T2DM. Regarding to Lipoprotein (a) levels among the majority of diabetic patients were within normal range (≤ 30 mg/dl) and it was noted that the Lp(a) levels were not related to IR or T2DM . In addition to that there is no interference between levels of vitamin D and p(a) levels with respect to IR .