Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA.
Am J Clin Nutr. 2013 Apr;97(4):774-81. doi: 10.3945/ajcn.112.050013. Epub 2013 Feb 13.
Obese adolescents are at a greater risk of vitamin D deficiency because vitamin D is thought to be sequestered by excess adipose tissue. Poor vitamin D status has been associated with a higher prevalence of the metabolic syndrome, type 2 diabetes, or both in adults and adolescents.
The objective was to determine in obese adolescents the efficacy and safety of 4000 IU vitamin D3/d and whether subsequent increased circulating concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with improved markers of insulin sensitivity and resistance and reduced inflammation.
Obese adolescent patients [n = 35; mean ± SD age: 14.1 ± 2.8 y; BMI (in kg/m(2)): 39.8 ± 6.1; 25(OH)D: 19.6 ± 7.1 ng/mL] were recruited from the University of Missouri Adolescent Diabetes and Obesity Clinic and were randomly assigned to receive either vitamin D3 (4000 IU/d) or placebo as part of their standard care. Anthropometric measurements, inflammatory markers (IL-6, TNF-α, C-reactive protein), adipokines (leptin, adiponectin), fasting glucose, fasting insulin, and HOMA-IR values were measured at baseline and at 2 follow-up visits (3 and 6 mo).
After 6 mo, there were no significant differences in BMI, serum inflammatory markers, or plasma glucose concentrations between groups. Participants supplemented with vitamin D3 had increases in serum 25(OH)D concentrations (19.5 compared with 2.8 ng/mL for placebo; P < 0.001), fasting insulin (-6.5 compared with +1.2 μU/mL for placebo; P = 0.026), HOMA-IR (-1.363 compared with +0.27 for placebo; P = 0.033), and leptin-to-adiponectin ratio (-1.41 compared with +0.10 for placebo; P = 0.045). Inflammatory markers remained unchanged.
The correction of poor vitamin D status through dietary supplementation may be an effective addition to the standard treatment of obesity and its associated insulin resistance. This trial was registered at clinicaltrials.gov as NCT00994396.
肥胖青少年维生素 D 缺乏的风险更高，因为维生素 D 被认为被多余的脂肪组织所隔离。在成人和青少年中，维生素 D 状况不佳与代谢综合征、2 型糖尿病或两者的患病率较高有关。
目的是确定肥胖青少年中 4000IU 维生素 D3/d 的疗效和安全性，以及随后循环 25-羟维生素 D [25(OH)D]浓度的增加是否与改善胰岛素敏感性和抵抗的标志物以及降低炎症有关。
从密苏里大学青少年糖尿病和肥胖症诊所招募肥胖青少年患者[ n = 35；平均年龄 ± 标准差：14.1 ± 2.8 岁；体重指数（kg/m2）：39.8 ± 6.1；25(OH)D：19.6 ± 7.1ng/mL]，并随机分配接受维生素 D3（4000IU/d）或安慰剂作为其标准治疗的一部分。在基线和 2 次随访（3 和 6 个月）时测量人体测量学测量值、炎症标志物（IL-6、TNF-α、C 反应蛋白）、脂肪因子（瘦素、脂联素）、空腹血糖、空腹胰岛素和 HOMA-IR 值。
6 个月后，两组间 BMI、血清炎症标志物或血浆葡萄糖浓度无显著差异。补充维生素 D3 的患者血清 25(OH)D 浓度升高（与安慰剂相比为 19.5 与 2.8ng/mL；P < 0.001），空腹胰岛素降低（与安慰剂相比为-6.5 与+1.2μU/mL；P = 0.026），HOMA-IR 降低（与安慰剂相比为-1.363 与+0.27；P = 0.033），瘦素与脂联素比值降低（与安慰剂相比为-1.41 与+0.10；P = 0.045）。炎症标志物保持不变。
通过饮食补充纠正维生素 D 状态不佳可能是肥胖及其相关胰岛素抵抗标准治疗的有效补充。本试验在 clinicaltrials.gov 注册为 NCT00994396。
