Sugden J A, Davies J I, Witham M D, Morris A D, Struthers A D
Department of Clinical Pharmacology, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK.
Diabet Med. 2008 Mar;25(3):320-5. doi: 10.1111/j.1464-5491.2007.02360.x. Epub 2008 Feb 13.
To test whether a single large dose of vitamin D2 can improve endothelial function in patients with Type 2 diabetes mellitus and low serum 25-hydroxyvitamin D levels.
Double-blind, parallel group, placebo-controlled randomized trial. A single dose of 100,000 IU vitamin D2 or placebo was administered to patients with Type 2 diabetes over the winter, when levels of circulating 25-hydroxyvitamin D were likely to be lowest. Patients were enrolled if their baseline 25-hydroxyvitamin D level was < 50 nmol/l. Endothelial function and blood pressure were measured and fasting blood samples were taken at baseline and 8 weeks after administration of vitamin D.
Forty-nine per cent of subjects screened had 25-hydroxyvitamin D levels < 50 nmol/l. Thirty-four subjects completed the study, with a mean age of 64 years and a baseline 25-hydroxyvitamin D level of 38.3 nmol/l. Vitamin D supplementation increased 25-hydroxyvitamin D levels by 15.3 nmol/l relative to placebo and significantly improved flow mediated vasodilatation (FMD) of the brachial artery by 2.3%. The improvement in FMD remained significant after adjusting for changes in blood pressure. Vitamin D supplementation significantly decreased systolic blood pressure by 14 mmHg compared with placebo; this did not correlate with change in FMD.
Vitamin D insufficiency is common in patients with Type 2 diabetes during winter in Scotland. A single large dose of oral vitamin D2 improves endothelial function in patients with Type 2 diabetes and vitamin D insufficiency.
检测单次大剂量维生素D2能否改善2型糖尿病且血清25-羟基维生素D水平较低患者的内皮功能。
双盲、平行组、安慰剂对照随机试验。在冬季,当循环中的25-羟基维生素D水平可能最低时,给予2型糖尿病患者单次剂量100,000 IU维生素D2或安慰剂。如果患者的基线25-羟基维生素D水平<50 nmol/l,则纳入研究。在基线时以及给予维生素D后8周测量内皮功能和血压,并采集空腹血样。
筛查的受试者中有49%的25-羟基维生素D水平<50 nmol/l。34名受试者完成了研究,平均年龄64岁,基线25-羟基维生素D水平为38.3 nmol/l。与安慰剂相比,补充维生素D使25-羟基维生素D水平升高了15.3 nmol/l,并使肱动脉的血流介导的血管舒张(FMD)显著改善了2.3%。在调整血压变化后,FMD的改善仍然显著。与安慰剂相比,补充维生素D使收缩压显著降低了14 mmHg;这与FMD的变化无关。
在苏格兰冬季,2型糖尿病患者中维生素D不足很常见。单次大剂量口服维生素D2可改善2型糖尿病且维生素D不足患者的内皮功能。