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维生素 D 补充作为 T2DM 患者的辅助治疗:一项为期 18 个月的前瞻性干预研究。

Vitamin D supplementation as an adjuvant therapy for patients with T2DM: an 18-month prospective interventional study.

机构信息

Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Kingdom of Saudi Arabia.

出版信息

Cardiovasc Diabetol. 2012 Jul 18;11:85. doi: 10.1186/1475-2840-11-85.

Abstract

BACKGROUND

Vitamin D deficiency has been associated with impaired human insulin action, suggesting a role in the pathogenesis of diabetes mellitus type 2 (T2DM). In this prospective interventional study we investigated the effects of vitamin D3 supplementation on the metabolic profiles of Saudi T2DM subjects pre- and post-vitamin D supplementation over an 18-month period.

METHODS

T2DM Saudi subjects (men, N = 34: Age: 56.6 ± 8.7 yr, BMI, 29.1 ± 3.3 kg/m2; women, N = 58: Age: 51.2 ± 10.6 yr, BMI 34.3 ± 4.9 kg/m2;) were recruited and given 2000 IU vitamin D3 daily for 18 months. Anthropometrics and fasting blood were collected (0, 6, 12, 18 months) to monitor serum 25-hydroxyvitamin D using specific ELISA, and to determine metabolic profiles by standard methods.

RESULTS

In all subjects there was a significant increase in mean 25-hydroxyvitamin D levels from baseline (32.2 ± 1.5 nmol/L) to 18 months (54.7 ± 1.5 nmol/L; p < 0.001), as well as serum calcium (baseline = 2.3 ± 0.23 mmol/L vs. 18 months = 2.6 ± 0.1 mmol/L; p = 0.003). A significant decrease in LDL- (baseline = 4.4 ± 0.8 mmol/L vs. 18 months = 3.6 ± 0.8 mmol/L, p < 0.001] and total cholesterol (baseline = 5.4 ± 0.2 mmol/L vs. 18 months = 4.9 ± 0.3 mmol/L, p < 0.001) were noted, as well as a significant improvement in HOMA-β function (p = 0.002). Majority of the improvements elicited were more prominent in women than men.

CONCLUSION

In the Saudi T2DM population receiving oral Vitamin D3 supplementation (2000 IU/day), circulating 25-hydroxyvitamin D levels remained below normal 18 months after the onset of treatment. Yet, this "suboptimal" supplementation significantly improved lipid profile with a favorable change in HDL/LDL ratio, and HOMA-β function, which were more pronounced in T2DM females.

摘要

背景

维生素 D 缺乏与人类胰岛素功能受损有关,这表明其在 2 型糖尿病(T2DM)发病机制中发挥作用。在这项前瞻性干预研究中,我们调查了维生素 D3 补充剂对沙特 T2DM 患者代谢谱的影响,这些患者在接受维生素 D 补充剂治疗 18 个月前后的代谢谱都发生了变化。

方法

招募了 T2DM 沙特患者(男性,N=34:年龄:56.6±8.7 岁,BMI:29.1±3.3kg/m2;女性,N=58:年龄:51.2±10.6 岁,BMI:34.3±4.9kg/m2),并给予 2000IU 维生素 D3 每天补充 18 个月。收集人体测量学和空腹血液(0、6、12、18 个月),使用特定的 ELISA 监测血清 25-羟基维生素 D 水平,并使用标准方法确定代谢谱。

结果

所有患者的平均 25-羟基维生素 D 水平从基线(32.2±1.5nmol/L)增加到 18 个月(54.7±1.5nmol/L;p<0.001),血清钙也从基线(2.3±0.23mmol/L)增加到 18 个月(2.6±0.1mmol/L;p=0.003)。LDL-(基线=4.4±0.8mmol/L 与 18 个月=3.6±0.8mmol/L,p<0.001)和总胆固醇(基线=5.4±0.2mmol/L 与 18 个月=4.9±0.3mmol/L,p<0.001)显著下降,HOMA-β功能显著改善(p=0.002)。这些改善中,大多数在女性中比男性更为显著。

结论

在接受口服维生素 D3 补充剂(2000IU/天)的沙特 T2DM 人群中,治疗开始 18 个月后,循环 25-羟基维生素 D 水平仍低于正常水平。然而,这种“亚最佳”补充显著改善了血脂谱,使 HDL/LDL 比值和 HOMA-β 功能更有利,在 T2DM 女性中更为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f7d/3461474/10f08406fed6/1475-2840-11-85-1.jpg

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