慢性肾脏病中的维生素D与葡萄糖代谢
Vitamin D and glucose metabolism in chronic kidney disease.
作者信息
de Boer Ian H
机构信息
Division of Nephrology, University of Washington, Seattle, Washington 98195, USA.
出版信息
Curr Opin Nephrol Hypertens. 2008 Nov;17(6):566-72. doi: 10.1097/MNH.0b013e32830fe377.
PURPOSE OF REVIEW
Vitamin D deficiency has been linked with impaired glucose metabolism, an established risk factor for cardiovascular disease. Effects of vitamin D may be particularly important in chronic kidney disease, because vitamin D metabolism is substantially impaired in this setting. The present review examines the potential role of vitamin D in improving glucose metabolism and clinical health outcomes in chronic kidney disease.
RECENT FINDINGS
Impaired glucose metabolism is common in chronic kidney disease. Short-term studies on maintenance hemodialysis patients have shown that vitamin D treatment improves insulin secretion and sensitivity. Intervention studies on people without end-stage renal disease have yielded mixed results. Mounting evidence from observational studies links vitamin D treatment with decreased mortality.
SUMMARY
Vitamin D therapy holds promise for improving health outcomes in chronic kidney disease. Improved glucose metabolism is one potential mechanism through which vitamin D may exert beneficial effects. However, further data from clinical trials are needed to test whether vitamin D has clinically relevant long-term effects on glucose metabolism and overall clinical outcomes.
综述目的
维生素D缺乏与葡萄糖代谢受损有关，而葡萄糖代谢受损是心血管疾病的既定风险因素。维生素D的作用在慢性肾脏病中可能尤为重要，因为在此情况下维生素D代谢会严重受损。本综述探讨了维生素D在改善慢性肾脏病患者葡萄糖代谢及临床健康结局方面的潜在作用。
最新发现
葡萄糖代谢受损在慢性肾脏病中很常见。对维持性血液透析患者的短期研究表明，维生素D治疗可改善胰岛素分泌和敏感性。对非终末期肾病患者的干预研究结果不一。观察性研究的证据越来越多地表明，维生素D治疗与死亡率降低有关。
总结
维生素D治疗有望改善慢性肾脏病患者的健康结局。改善葡萄糖代谢是维生素D可能发挥有益作用的一种潜在机制。然而，需要来自临床试验的进一步数据来检验维生素D对葡萄糖代谢和总体临床结局是否具有临床相关的长期影响。
Zotero 插件