维生素D与2型痛性糖尿病周围神经病变的研究进展

阿尼 呢嘎, 金晨 爽1, 王源 岚1, 卢雪 玲2
1.新疆医科大学第二临床医学院 乌鲁木齐 830054 2.新疆医科大学第七附属医院内分泌科 乌鲁木齐 830092

摘要

摘要：维生素D在骨代谢、钙代谢中发挥重大影响。国内外研究已经证实维生素D不足和糖尿病的发病及并发症的进展密切相关。糖尿病周围神经病变(DPN)是糖尿病微血管并发症之一，而痛性糖尿病周围神经病变（PDPN）又称糖尿病周围神经病理性疼痛。PDPN可导致严重疼痛、运动受限，生活质量下滑。Basit[1]临床试验表明，高剂量肌肉注射维生素D可有效缓解患者的疼痛症状。有研究表明口服维生素D补充剂可改善维生素D和周围神经功能[2]。Razzaghi[3]研究表明，补充维生素D有利于糖尿病足溃疡的创面愈合。综上所述，维生素D是PDPN的重要因素。本文拟分析已开展的研究，将近年来国内外就二者的相关性研究进行归纳、总结。

关键词

关键词：维生素D；2型糖尿病；痛性糖尿病周围神经病变

参考

[1] Basit A, Basit KA, Fawwad A, et al. Vitamin D for the treatment ofpainful diabetic neuropathy. BMJ Open Diabetes Res Care 2016;4: e000148.[2] Shehab D, Al-Jarallah K, Abdella N, et al. Prospective evaluation ofthe effect of short-term oral vitamin d supplementation on peripheralneuropathy in type 2 diabetes mellitus. Medical principles and practice:international journal of the Kuwait University, Health Science Centre2015;24:250–6.[3] Razzaghi R, Pourbagheri H, Momen-Heravi M, et al. The effects ofvitamin D supplementation on wound healing and metabolic status in patientswith diabetic foot ulcer: a randomized, double-blind, placebocontrolled trial. JDiabetes Complications 2017;31:766-72.[4] 毛琳,李莉.2 型糖尿病患者血清维生素 D 水平及其影响因素[J].中国医科大学学报，2017，46（1）:68-71.[5] 中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指(2017)[J].中国骨质疏松杂志,2019,25(3):281-309.[6] He R, Hu Y, Zeng H, et al. (2016) Vitamin D deficiency increases therisk of peripheral neuropathy in Chinese patients with type 2 diabetes.Diabetes Metab Res Rev 33.[7] Ahmadieh H, Azar ST, Lakkis N, et al. (2013) Hypovitaminosis D inPatients with Type 2 Diabetes Mellitus: A Relation to Disease Control andComplications. ISRN Endocrinol 2013,1-7.[8] Fan L, Zhang Y, Zhu J, et al. (2018) Association of vitamin Ddeficiency with diabetic peripheral neuropathy and diabetic nephropathy intianjin, china. Asia Pac J Clin Nutr 27, 599-606.[9] Yammine K, Wehbe R, Assi C. A systematic review on the efficacy ofvitamin D supplementation on diabetic peripheral neuropathy. Clin Nutr2020;Feb 4:S0261-5614(20)30045-5.[10] Jmbart s, Ammache Z, Haddad F, et al. Prevalence of PainfulDiabetic Peripheral Neuropathy among Patients with Dtabetes Mellitus in theMiddle East Region[J].J Int Med Res, 2011, 39(2):366-377.[11] Abbott CA, Malik RA, Van Ross ERE, et al. Prevalence andCharacteristics of Painful Diabetic Neuopathy in a Large Community BasedDiabetic Population in the U.K [J]. Diabetes Care, 2011, 34(10):2220-2224[12] Acker KV, Bouhassira D, Bacquer DD, et al. Prevalence and impacton quality of life of peripheral neuopathy with or without neuropathic pain intype 1 and type 2 diabetic patients attending hospital outpatients clinics[J]Diabetes Metab, 2009,35(3):206-213.[13] 雷舒煜，李亦梅.痛性糖尿病周围神经病变的临床研究进展[J].新疆医科大学校报增刊.[14] 杨思进，马依彤，刘芬，等.新疆维吾尔族、哈萨克族糖尿病的患病率调查及相关危险因素分析.中华内分泌代谢杂志. 2011,27(5):395-398.[15] Zhou Y-K, Liang Z, Guo Y, Zhang H-T, Wang K-H. Highglucose upregulates CYP24A1 expression which attenuates theability of 1,25(OH) 2D3 to increase NGF secretion in a rat Schwanncell line RSC96. Mol Cell Endocrinol 2015; 404: 75-81.[16] Anand P, Bley K. Topical capsaicin for pain management:therapeutic potential and mechanisms of action of the newhigh-concentration capsaicin 8% patch. Br J Anaesth 2011; 107:490-502.[17] Shillo P,Selvarajah D,Greig M,et al.Reduced vitamin D levels inpainful diabetic peripheral neuropathy [J].Diabetic Med,2019,36(1):44-51.[18] Basit A,Basit KA,Fawwad A,et al.Vitamin D for the treat-ment ofpainful diabetic neuropathy [J].BMJ Open Diabetes Res Care,2016,4(1):e000148[19] Alam Uazman et al. Vitamin D deficiency is associated with painfuldiabetic neuropathy.[J]. Diabetes/metabolism research and reviews, 2020,37(1) : e3361.[20] Palomer X, González-Clemente JM, Blanco-Vaca F, et al. (2008)Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. DiabetesObes Metab 10, 185-197.