Department of Medicine, Wolfson Medical Center, Israel.
Clin Nutr. 2013 Dec;32(6):970-5. doi: 10.1016/j.clnu.2013.01.020. Epub 2013 Feb 27.
BACKGROUND & AIMS: Vitamin D supplementation has the potential to alleviate the cardiovascular damage in diabetic patients. The present study was designed to evaluate long term impact of high doses of vitamin D on arterial properties, glucose homeostasis, adiponectin and leptin in patients with type 2 diabetes mellitus.
In randomized, placebo-controlled study 47 diabetic patients were assigned into two groups: Group 1 received oral daily supplementation with vitamin D at a dose of 1000 U/day for 12 months. Group 2 received matching placebo capsules. Blood sampling for metabolic parameters, including fasting glucose, lipid profile, HbA1C, insulin, hs-CRP, 25 OH Vit D, adiponectin and leptin was performed at baseline and at the end of the study. Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Central aortic augmentation index (AI) was evaluated using SphygmoCor.
The two groups were similar at baseline in terms of hemodynamic parameters. After 12 months, AI decreased significantly during the treatment period in patients received vitamin D (p < 0.0001) and did not change in placebo group. Glucose homeostasis parameters, leptin as well as leptin adiponectin ratio did not change in both groups. 25 OH Vit D level significantly increased (p = 0.022) and circulating adiponectin marginally increased (p = 0.065) during 12 month treatment period in active treatment and did not change in placebo group.
High doses of vitamin D supplementation in diabetic patients was associated with significant decrease in AI during one year treatment. This beneficial vascular effect was not associated with improvement in glucose homeostasis parameters.
维生素 D 补充剂有可能减轻糖尿病患者的心血管损伤。本研究旨在评估大剂量维生素 D 对 2 型糖尿病患者动脉功能、葡萄糖稳态、脂联素和瘦素的长期影响。
在随机、安慰剂对照研究中,将 47 例糖尿病患者分为两组:第 1 组每天口服补充维生素 D,剂量为 1000U/天,持续 12 个月;第 2 组给予匹配的安慰剂胶囊。在基线和研究结束时采集代谢参数(包括空腹血糖、血脂谱、HbA1C、胰岛素、hs-CRP、25-羟维生素 D、脂联素和瘦素)的血样。通过稳态模型评估(HOMA-IR)评估胰岛素抵抗。使用 SphygmoCor 评估中心主动脉增强指数(AI)。
两组患者在基线时的血流动力学参数相似。12 个月后,接受维生素 D 治疗的患者 AI 在治疗期间显著下降(p < 0.0001),而安慰剂组无变化。两组患者的葡萄糖稳态参数、瘦素以及瘦素-脂联素比值均无变化。在 12 个月的治疗期间,活性治疗组 25-羟维生素 D 水平显著升高(p = 0.022),循环脂联素略有升高(p = 0.065),而安慰剂组无变化。
糖尿病患者大剂量维生素 D 补充与一年治疗期间 AI 的显著下降相关。这种有益的血管作用与葡萄糖稳态参数的改善无关。