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老年糖尿病患者的维生素D缺乏、血清瘦素和骨保护素水平:新研究途径的切入点

Vitamin D deficiency, serum leptin and osteoprotegerin levels in older diabetic patients: an input to new research avenues.

作者信息

Maggi Stefania, Siviero Paola, Brocco Enrico, Albertin Massimo, Romanato Giovanna, Crepaldi Gaetano

机构信息

CNR Aging Branch, Institute of Neuroscience, Via Giustiniani 2, 35128, Padua, Italy.

出版信息

Acta Diabetol. 2014;51(3):461-9. doi: 10.1007/s00592-013-0540-4. Epub 2013 Dec 20.

Abstract

The aim of this study was to assess the effects of single oral bolus of 300,000 IU Vitamin D3 on serum levels and on bone and metabolic parameters in diabetic patients. This study is a Phase IV, randomized, double-blind, placebo-controlled, monocenter clinical trial. Thirty patients, 60 years or older, with type 2 diabetes mellitus, and diabetic foot complications, were enrolled and monitored for 24 weeks: 14 were treated with Vitamin D3 and 16 with placebo. Parameters including glucose, adiponectin, leptin, osteoprotegerin (OPG), 25-hydroxyvitamin D [25(OH)D], beta-CrossLaps, osteocalcin, bone-specific isoenzyme of alkaline phosphatase, tumor necrosis factor-α and parathyroid hormone were measured at screening and baseline and 12 and 24 weeks after treatment. Analysis of covariance was used to compare treatment groups. Analysis of the data detected a significant increase in 25(OH)D serum levels both at 12 and 24 weeks with respect to baseline values only in the treated patients. Significant variations with respect to baseline values were noted in OPG (P = 0.0085) and in leptin (P = 0.0442) levels: these were lower in the placebo group at week 24 but higher in the treated group. Vitamin D3 supplementation significantly increased serum leptin and OPG levels. Further, large-scale clinical trials are warranted to confirm these results.

摘要

本研究旨在评估单次口服300,000国际单位维生素D3对糖尿病患者血清水平以及骨骼和代谢参数的影响。本研究为一项IV期、随机、双盲、安慰剂对照、单中心临床试验。纳入了30例60岁及以上的2型糖尿病合并糖尿病足并发症患者,并对其进行了24周的监测:14例接受维生素D3治疗,16例接受安慰剂治疗。在筛查、基线以及治疗后12周和24周测量了包括血糖、脂联素、瘦素、骨保护素(OPG)、25-羟基维生素D [25(OH)D]、β-交联羧基末端肽、骨钙素、骨特异性碱性磷酸酶同工酶、肿瘤坏死因子-α和甲状旁腺激素等参数。采用协方差分析比较治疗组。数据分析发现,仅在接受治疗的患者中,12周和24周时25(OH)D血清水平相对于基线值有显著升高。观察到OPG(P = 0.0085)和瘦素(P = 0.0442)水平相对于基线值有显著变化:在第24周时,安慰剂组较低,而治疗组较高。补充维生素D3显著提高了血清瘦素和OPG水平。此外,需要进行大规模临床试验来证实这些结果。

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