Ahmadi Nooshin, Mortazavi Mojgan, Iraj Bijan, Askari Gholamreza
Resident of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences,Isfahan, Iran.
J Res Med Sci. 2013 May;18(5):374-7.
Nowadays Vitamin D deficiency is a notable medical condition world-wide and also in Iran. Since, vitamin D can have renoprotective effect by inhibiting the renin-angiotensin system; it appears that low vitamin D level can worsen the renal injury in diabetic patients. This study demonstrates the effect of vitamin D3 therapy on reducing proteinuria in diabetic patients with concomitant diabetic nephropathy and vitamin D deficiency after controlling hypertension and use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II type receptor blockers (ARBs).
In this randomized double blinded parallel groups clinical trial, 51 diabetic patients with proven nephropathy and vitamin D deficiency/insufficiency and stable hypertension, dyslipidemia, and hyperglycemic treatment were enrolled. The patients were divided randomly into two groups (treatment and placebo group). Patients received oral vitamin D3 (pearl 50000 IU) or placebo one pearl every week for 12 weeks. Patients were assessed at baseline and 12 weeks after intervention from the point of 25(OH) D level, and urine albumin/creatinine ration (UACR).
Mean serum 25(OH) D concentrations were 14.06 ng/ml and 16.05 ng/ml before treatment. Furthermore, after intervention, its levels were risen to 71.23 and 17.63 in drug and placebo groups, respectively. Whereas, UACR as the main variable did not change significantly after intervention in both groups (P = 0.919).
According to our finding, there was not a decrease in proteinuria in diabetic patients who received vitamin D for a period of 3 months.
如今,维生素D缺乏在全球范围内以及伊朗都是一个显著的医学问题。由于维生素D可通过抑制肾素-血管紧张素系统发挥肾脏保护作用;因此,维生素D水平低似乎会加重糖尿病患者的肾脏损伤。本研究旨在探讨在控制高血压并使用血管紧张素转换酶抑制剂(ACEIs)或血管紧张素II受体阻滞剂(ARBs)后,维生素D3治疗对伴有糖尿病肾病和维生素D缺乏的糖尿病患者降低蛋白尿的效果。
在这项随机双盲平行组临床试验中,纳入了51例确诊为肾病且维生素D缺乏/不足、高血压、血脂异常和血糖治疗稳定的糖尿病患者。患者被随机分为两组(治疗组和安慰剂组)。患者每周口服一粒维生素D3(50000 IU滴丸)或安慰剂,共12周。在基线和干预12周后,从25(OH)D水平和尿白蛋白/肌酐比值(UACR)方面对患者进行评估。
治疗前血清25(OH)D平均浓度分别为14.06 ng/ml和16.05 ng/ml。此外,干预后,药物组和安慰剂组的该水平分别升至71.23和17.63。然而,作为主要变量的UACR在两组干预后均无显著变化(P = 0.919)。
根据我们的研究结果,接受维生素D治疗3个月的糖尿病患者蛋白尿并未减少。