ÃÖ½Å³í¹®¸®ºä
   
Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation
±Û¾´ÀÌ : °ü¸®ÀÚ ³¯Â¥ : 2018-04-02 (¿ù) 11:38 Á¶È¸ : 1832
Á¶Èñ°æ ¼±»ý´Ô(´ç´¢¹ß).pdf (1.4M), Down : 1, 2018-04-02 15:15:07

Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation

 

Uazman Alam, Asher Fawwad, Fariha Shaheen, Bilal Tahir, Abdul Basit, and Rayaz A. Malik,

Gait & Posture 58 (2017) 72–77

 

 

Introduction

ÅëÁõÀÌ µ¿¹ÝµÈ ´ç´¢º´¼º ½Å°æº´ÁõÀº ¹ß ´Ù¸®¿¡ Àú¸°°¨, Ÿ´ÂµíÇÑ ¾ç»ó, È­²ö°Å¸² µî°ú °°Àº ÅëÁõÀ» ¾ß±âÇÏ¸ç »îÀÇ ÁúÀ» Å©°Ô ÀúÇϽÃŲ´Ù. ºñŸ¹Î D °áÇÌ ±× ÀÚü°¡ ´ç´¢º´¼º ½Å°æº´Áõ°ú ¹ÐÁ¢ÇÑ ¿¬°ü°ü°è°¡ ÀÖ´Â °ÍÀ¸·Î ¾Ë·ÁÁ® ÀÖ´Ù. ÇÑ ¿¬±¸¿¡ µû¸£¸é ºñŸ¹Î D °áÇÌÀÌ ´ç´¢º´¼º ½Å°æº´ÁõÀÌ Àִ ȯÀÚÀÇ ÃÖ´ë 82%¿¡¼­ ¹ß»ýÇß´Ù°í º¸°íÇÏ¿´´Ù. ¶ÇÇÑ ÃÖ±Ù, ºñŸ¹Î D °áÇÌÀÌ ´ç´¢º´¼º ½Å°æº´ÁõÀÇ µ¶¸³ÀûÀÎ À§Çè ÀÎÀÚ·Î º¸°íµÇ¾ú´Ù.  º» ¿¬±¸ÀÇ ¸ñÀûÀº ÅëÁõÀÌ µ¿¹ÝµÈ ´ç´¢º´¼º ½Å°æº´Áõ ȯÀÚ¿¡°Ô °í¿ë·® ºñŸ¹Î D ±ÙÀ° ÁÖ»ç Ä¡·á¸¦ ½ÃÇàÇÏ¿´À» ¶§ »îÀÇ Áú¿¡ ¹ÌÄ¡´Â ¿µÇâ¿¡ ´ëÇÏ¿© Æò°¡ÇÏ°íÀÚ ÇÏ¿´´Ù.

Methods

- 18¼¼ ÀÌ»óÀÇ Áõ»óÀÌ µ¿¹ÝµÈ ´ç´¢º´¼º ½Å°æº´Áõ ȯÀÚ.

- HbA1C ¡Â 11 % with no comorbidities.

- ±ÙÀ° ³» ºñŸ¹Î D3 600,000 U ´ÜÀÏ ÁÖ»ç ÈÄ ¸Å 4ÁÖ¸¶´Ù ÃÑ 5¹ø follow-upÇÔ.

- Serum 25(OH)D ÃøÁ¤ÇÔ.

- Endocrine Society Clinical Practice Guideline, 2011¿¡ ±Ù°ÅÇÏ¿© Deficiency as 25(OH)D < 20 ng/ml, Insufficiency as 25(OH)D 20-30 ng/ml, Adequacy as 25(OH)D ¡Ã 30 ng/ml·Î Á¤ÀÇ ³»¸².


Neuropathy Specific Quality of Life Questionnaire (NeuroQoL)

- 6°³ÀÇ ¼ÒºÐ·ù·Î ³ª´©¾îÁø 27°¡ÁöÀÇ ¼³¹® ½ÃÇàÇÔ.

1) Painful symptoms and paresthesia

2) Reduction or loss of ability to feel temperature and/or objects with the feet

3) Unsteadiness while standing/ walking

4) Limitation in daily activities

5) Interpersonal problems, for example, physical/emotional dependence on others

6) Emotional distress

- Áõ»ó ºóµµ¸¦ 1ºÎÅÍ 5±îÁö ºÐ·ùÇÔ(1:¡±never¡±, 5: ¡°all the time¡±)

Results

- 40% ȯÀÚ¿¡¼­ ºñŸ¹Î D deficient, 17% ȯÀÚ¿¡¼­ ºñŸ¹Î D insufficient, 43% ȯÀÚ¿¡¼­ ºñŸ¹Î D sufficient ¼Ò°ß °üÂûµÊ (Table 1 ÂüÁ¶)



 Effect of Treatment with Vitamin D

- ºñŸ¹Î D Ä¡·á ÈÄ 25(OH)D Áõ°¡»Ó¸¸ ¾Æ´Ï¶ó Calcium, HDL Áõ°¡ ¹× HbA1c °¨¼Ò °üÂûµÊ (Table 2 ÂüÁ¶).

- ºñŸ¹Î D Ä¡·á ÈÄ visit 3ºÎÅÍ NeuroQoLÀÇ emotional distress ¿µ¿ªÀÇ ÀÇ¹Ì Àִ ȣÀü °üÂûµÊ (Table 3 ÂüÁ¶).

- ºñŸ¹Î D Ä¡·á ÈÄ QoL¿¡¼­ ¹ß ¹®Á¦¿¡ ´ëÇÑ È¯ÀÚÀÇ ÀνĿ¡¼­ ¡°quite a lot¡±°ú ¡°very much¡±¶ó°í ¹ÝÀÀÇÏ´Â ÆÛ¼¾Æ®°¡ Å©°Ô °¨¼ÒÇÔ.

- ºñŸ¹Î D Ä¡·á ÈÄ QoL¿¡¼­ ¡°poor QoL¡± ÀÀ´äÀÌ 5.2%¿¡¼­ 0.7%·Î ´ëÆø °¨¼ÒÇßÀ¸¸ç ¡°excellent QoL¡± ÀÀ´äÀÌ 1.5%¿¡¼­ 7.4%·Î Áõ°¡ÇÔ (Fig 1 ÂüÁ¶).




Conclusion

´ç´¢¿Í ÅëÁõÀÌ µ¿¹ÝµÈ ´ç´¢º´¼º ½Å°æº´ÁõÀº »îÀÇ ÁúÀÇ Ç϶ôÀ» ¾ß±â½ÃŲ´Ù. ÀÌ ¿¬±¸ÀÇ ÁÖ¿ä °á°ú´Â °í¿ë·®ÀÇ ºñŸ¹Î D ´ÜÀÏ ÁÖ»ç Ä¡·á ÈÄ NeuroQoLÀÇ emotional distress ¿µ¿ª¿¡¼­ ÀÇ¹Ì Àִ ȣÀüÀÌ °üÂûµÇ¾úÀ¸¸ç, »îÀÇ Áú¿¡ ´ëÇÑ Àü¹ÝÀûÀΠȯÀÚÀÇ ÀνÄ, ƯÈ÷ ºñŸ¹Î D Ä¡·á ÈÄ ¹ß ¹®Á¦¿¡ ´ëÇÑ È¯ÀÚ ÀνĿ¡ À־ÀÇ °³¼±À» º¸¿©ÁÖ¾ú´Ù. ¶ÇÇÑ Ç÷Áß ºñŸ¹Î D ¼öÄ¡»Ó¸¸ ¾Æ´Ï¶ó HbA1c¿Í HDLÀÇ È£ÀüÀÌ °üÂûµÇ¾ú´Ù.


À̸§ Æнº¿öµå
ºñ¹Ð±Û (üũÇÏ¸é ±Û¾´À̸¸ ³»¿ëÀ» È®ÀÎÇÒ ¼ö ÀÖ½À´Ï´Ù.)
¿ÞÂÊÀÇ ±ÛÀÚ¸¦ ÀÔ·ÂÇϼ¼¿ä.