No abstract

Оригінальні дослідження /Original Researches/ Вступ Цукровий діабет (ЦД) визначений Всесвітньою організацією охорони здоров'я (ВООЗ) як неінфекційна епідемія, саме у зв'язку з цим 2006 року ухвалено резолюцію ООН про боротьбу з ЦД. Якщо на початку 80-х років минулого століття число хворих на ЦД становило близько 30 млн, то у 2015 році у світі зареєстровано близько 422 млн осіб із ЦД. За прогнозами експертів ВООЗ та Міжнародної діабетичної федерації, до 2040 року очікується, що ця цифра сягне понад 642 млн [1, 2]. В Україні станом на 2013 рік зареєстровано понад 1,3 млн пацієнтів, а щорічний приріст оцінюється в 4-5 % [3, 4]. Поширеність ЦД в усьому світі швидко зростає і досягає в середньому 2-4 % від загальної популяції. З віком частота ЦД зростає, досягаючи в осіб, старших від 65 років, 7-8 % [4].

Background. Recently, vitamin D 3 deficiency is consi dered one of the factors associated with the develop ment of nonalcoholic fatty liver disease (NAFLD). The aim was to evaluate steatosis indices and metabolic parameters in NAFLD depending on vitamin D 3 status. Methods. According to the recommendations of the European Society of Endocrinology, all patients were divided into 3 groups: group 1-with an optimal level of vitamin D 3 (30 ng/mL); group 2-vitamin D 3 insufficiency (21-29 ng/mL) and group 3-vitamin D 3 deficiency (< 20 ng/mL). Results. The study included 126 T2D patients with NAFLD diagnosed with ultrasound. The highest hepatic steatosis (HSI) and fatty liver (FLI) index values were diagnosed in vitamin D 3 deficiency as compared to optimal group (HSI-43.34 ± 6.59 vs. 39.67 ± 4.37; P = 0.032 and FLI-79.21 ± 19.61 vs. 64.96 ± 17.72; P = 0.007). Triglyceride and glucose index (TyG) also were insignificantly elevated parallel to vitamin D 3 status worsened (P = 0.175). In multivariate logistic re gression analysis all steatosis indices were independent from transaminases activity, body mass index (BMI) and T2D duration associated with vitamin D 3 deficiency. Conclusions. Hepatic steatosis indices (HSI, FLI and TyG) independently from anthropometric parameters and transaminase activity associated with D 3 deficiency in

Background. Recently, vitamin D deficiency has been considered one of the factors in the development of type 2 diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). The purpose was to establish the effectiveness of Decap (cholecalcife­rol) in patients with its deficiency who suffered from type 2 DM and NAFLD. Materials and methods. Fifty-two people with NAFLD and type 2 DM on the background of established D-deficiency were treated, they were evenly divided into two groups. Patients in the comparison group (n = 26) received only traditional antidiabetic therapy, and the main group (n = 26) additio­nally took vitamin D — Decap, which was prescribed at a dose of 4,000 IU/day for 6 months. Results. Vitamin D use was associated with a statistically significant reduction in fasting blood glucose after 6 months of treatment — by 4.2 % (p = 0.041). The level of glycated hemoglobin in the main group of patients decreased on ave­rage by 0.38 % (p = 0.121) after 3 months, and remained almost at the same level after 6 months — by 0.44 % (p = 0.088). In parallel with the improvement of glycemic control parameters in the main group, there was a tendency to a decrease in the HOMA-2-IR by 0.28 (–0.11; 0.86; p = 0.152) and to a better insulin sensitivity by 1.39 (–10.04; 6.01; p = 0.621) compared to the baseline. The use of vitamin D (Decap) is associated with a decrease in steatosis indices FLI and TyG. The baseline values for FLI was 74.11 ± 18.71 and for TyG — 5.21 ± 0.29, and after a six-month course of vitamin D treatment, they decreased by 4.4 % (p = 0.029) and 2.68 % (p = 0.031), respectively, compared to baseline. Conclusions. It was found that the use of Decap in patients with vitamin D deficiency at a dose of 4,000 IU/day for a course of at least six months improved glycemic control and metabolic profile in those with type 2 DM and NAFLD.