PDF(Pubmed)
Abstract：
Vitamin D is known to have a positive effect on bone health. Despite the greater frequency of vitamin D deficiency in African Americans (AA), they have a higher bone mineral density (BMD) compared to whites, demonstrating a disconnect between BMD and vitamin D levels in AA. Another intriguing relationship seen in AA is the triglyceride (TG) paradox, an unusual phenomenon in which a normal TG status is observed even when patients house conditions known to be characterized by high TG levels, such as Type II diabetes. To the best of our knowledge, no study has examined whether these two paradoxical relationships exist simultaneously in AA subjects with Type II diabetes. In this study, we compared levels of blood markers, including HbA1c, TG, and vitamin D, measured as serum 25-hydroxyvitamin D [25(OH)VD] µM/mL, [25(OH)VD]/TG, calcium, and BMD in AA (n = 56) and white (n = 26) subjects with Type II diabetes to see whether these relationships exist concurrently. We found that AA subjects had significantly lower TG and [25(OH)VD] levels and a significantly higher BMD status compared to white subjects, even when the ages, BMI, duration of diabetes, HbA1c, and calcium levels were similar between the two groups. This demonstrates that these two paradoxical relationships exist simultaneously in Type II diabetic AA subjects. In addition to these findings, we discuss the current hypotheses in the literature that attempt to explain why these two intriguing relationships exist. This review also discusses four novel hypotheses, such as altered circulating levels and the potential role of estrogen and hydrogen sulfide on BMD and HMG-CoA reductase as a possible contributor to the TG paradox in AA subjects. This manuscript demonstrates that there are still many unanswered questions regarding these two paradoxical relationships and further research is needed to determine why they exist and how they can be implemented to improve healthcare.
摘要：
已知维生素D对骨骼健康有积极影响。尽管非洲裔美国人（AA）维生素D缺乏的频率更高，与白人相比，他们的骨矿物质密度(BMD)更高，证明AA中BMD和维生素D水平之间存在脱节。在AA中看到的另一个有趣的关系是甘油三酯（TG）悖论，一种不寻常的现象，即使患者居住条件已知为高TG水平，也能观察到正常的TG状态。例如II型糖尿病。据我们所知,没有研究检查在II型糖尿病的AA受试者中是否同时存在这两种矛盾关系。在这项研究中,我们比较了血液标志物的水平，包括HbA1c,TG,还有维生素D,以血清25-羟基维生素D[25（OH）VD]µM/mL测量，[25(OH)VD]/TG,钙，AA（n=56）和白人（n=26）II型糖尿病受试者的BMD，以查看这些关系是否同时存在。我们发现，与白人受试者相比，AA受试者的TG和[25（OH）VD]水平显着降低，BMD状态显着升高。即使年龄，BMI,糖尿病的持续时间，HbA1c,两组之间的钙水平相似。这表明这两种矛盾的关系同时存在于II型糖尿病AA受试者中。除了这些发现,我们在文献中讨论当前的假设，试图解释为什么这两个有趣的关系存在。这篇综述还讨论了四个新颖的假设，例如循环水平的改变以及雌激素和硫化氢对BMD和HMG-CoA还原酶的潜在作用，可能是AA受试者TG悖论的原因。这份手稿表明，关于这两种矛盾的关系，仍然有许多悬而未决的问题，需要进一步的研究来确定它们存在的原因以及如何实施以改善医疗保健。
