RESUMO
Objective To investigate the relationship of serum level of 25 hydroxyl vitamin D3 [25(OH)D3 ] with insulin resistance (IR) and bone metabolism in diabetic patients with chronic kidney disease (CKD) . Methods From April 2012 to February 2014 ,200 diabetic patients with CKD were selected ,and they were divided into three groups according to eGFR:60 subjects in eGFR> 45 ~ 59 ml/(min?1.73 m2 ) group ,60 subjects in eGFR 30~44 ml/(min?1.73 m2 ) group and 80 subjects in eGFR 15~29 ml/(min?1.73 m2 ) group .Clinical features ,IR and indexes of bone metabolism among different groups were compared .Indexes of bone metabolism between two groups with different HOMA‐IR level were also compared . Results The difference of age ,gender ,BMI ,blood pressure and FPG among three groups had no statistical significance (P> 0 .05) .The difference of duration of diabetes mellitus ,duration of CKD ,urine protein ,blood lipid ,eGFR ,HbA1c ,FIns ,HOMA‐IR and indexes of bone metabolism had statistical significance (P< 0.05) .In 200 patients ,there were 129 patients (IR) with HOMA‐IR≥3.28 ,and 71 patients (non‐insulin resistance) with HOMA‐IR<3.28 .The difference of bone metabolism indexes between two groups had statistical significance (P<0.05) .The serum level of 25(OH)D3 was positively related to HOMA‐IR ,bone mineral density (BMD) at left proximal femur , BMD at lumbar ,P ,Ca and BSAP (P<0.05);while it was negatively related to osteoprotegerin and PTH (P<0 .05) . Conclusion The serum level of 25 (OH )D3 has relevance to IR and bone metabolism in diabetic patients with CKD .
