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减肥期间补充维生素D3:一项双盲随机对照试验。

Vitamin D3 supplementation during weight loss: a double-blind randomized controlled trial.

作者信息

Mason Caitlin, Xiao Liren, Imayama Ikuyo, Duggan Catherine, Wang Ching-Yun, Korde Larissa, McTiernan Anne

机构信息

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (CM, LX, II, CD, C-YW, LK, and AM), and the Department of Epidemiology, School of Public Health (AM), the Department of Biostatistics, School of Public Health (C-YW), and the Department of Medicine (LK), University of Washington, Seattle, WA.

出版信息

Am J Clin Nutr. 2014 May;99(5):1015-25. doi: 10.3945/ajcn.113.073734. Epub 2014 Mar 12.

Abstract

BACKGROUND

Vitamin D deficiency is associated with obesity; whether repletion supports weight loss and changes obesity-related biomarkers is unknown.

OBJECTIVE

We compared 12 mo of vitamin D3 supplementation with placebo on weight, body composition, insulin, and C-reactive protein (CRP) in postmenopausal women in a weight-loss intervention.

DESIGN

A total of 218 overweight/obese women (50-75 y of age) with serum 25-hydroxyvitamin D [25(OH)D] ≥10 ng/mL but <32 ng/mL were randomly assigned to weight loss + 2000 IU oral vitamin D3/d or weight loss + daily placebo. The weight-loss intervention included a reduced-calorie diet (10% weight loss goal) and 225 min/wk of moderate-to-vigorous aerobic activity. Mean 12-mo changes in weight, body composition, serum insulin, CRP, and 25(OH)D were compared between groups (intent-to-treat) by using generalized estimating equations.

RESULTS

A total of 86% of participants completed the 12-mo measurements. The mean (95% CI) change in 25(OH)D was 13.6 (11.6, 15.4) ng/mL in the vitamin D3 arm compared with -1.3 (-2.6, -0.3) ng/mL in the placebo arm (P < 0.0001). Changes in weight [-7.1 (-8.7, -5.7) compared with -7.4 (-8.1, -5.4) kg], body mass index (in kg/m(2): both -2.8), waist circumference [-4.9 (-6.7, -2.9) compared with -4.5 (-5.6, -2.6) cm], percentage body fat [-4.1 (-4.9, -2.9) compared with -3.5 (-4.5, -2.5)], trunk fat [-4.1 (-4.7, -3.0) compared with -3.7 (-4.3, -2.9) kg], insulin [-2.5 (-3.4, -1.7) compared with -2.4 (-3.3, -1.4) μU/mL], and CRP [-0.9 (-1.2, -0.6) compared with -0.79 (-0.9, -0.4) mg/L] [corrected] were similar between groups (all P > 0.05). Compared with women who achieved 25(OH)D <32 ng/mL, women randomly assigned to vitamin D who became replete (ie, 25(OH)D ≥32 ng/mL) lost more weight [-8.8 (-11.1, -6.9) compared with -5.6 (-7.2, -5.0) kg; P = 0.05], waist circumference [-6.6 (-9.3, -4.3) compared with -2.5 (-4.6, -2.0) cm; P = 0.02], and percentage body fat [-4.7 (-6.1, -3.5) compared with -2.6 (-3.9, -2.2); P = 0.04]. Among women with complete pill counts (97% adherence), the mean decrease in CRP was 1.18 mg/mL (46%) in the vitamin D arm compared with 0.46 mg/mL (25%) in the placebo arm (P = 0.03).

CONCLUSIONS

Vitamin D3 supplementation during weight loss did not increase weight loss or associated factors compared with placebo; however, women who became replete experienced greater improvements. This trial was registered at clinicaltrials.gov as NCT01240213.

摘要

背景

维生素D缺乏与肥胖相关;维生素D补充是否有助于体重减轻以及是否会改变肥胖相关生物标志物尚不清楚。

目的

在一项减肥干预中,我们比较了补充12个月维生素D3与安慰剂对绝经后女性体重、身体成分、胰岛素和C反应蛋白(CRP)的影响。

设计

共有218名超重/肥胖女性(年龄50 - 75岁),血清25 - 羟基维生素D [25(OH)D]≥10 ng/mL但<32 ng/mL,被随机分配至减肥 + 每日口服2000 IU维生素D3组或减肥 + 每日安慰剂组。减肥干预包括低热量饮食(减重目标为10%)和每周225分钟的中等到剧烈有氧运动。通过广义估计方程比较两组间(意向性分析)体重、身体成分、血清胰岛素、CRP和25(OH)D的12个月平均变化。

结果

共有86%的参与者完成了12个月的测量。维生素D3组25(OH)D的平均(95%CI)变化为13.6(11.6,15.4)ng/mL,而安慰剂组为 - 1.3( - 2.6, - 0.3)ng/mL(P < 0.0001)。两组间体重[-7.1( - 8.7, - 5.7)与 - 7.4( - 8.1, - 5.4)kg]、体重指数(单位:kg/m²:均为 - 2.8)、腰围[-4.9( - 6.7, - 2.9)与 - 4.5( - 5.6, - 2.6)cm]、体脂百分比[-4.1( - 4.9, - 2.9)与 - 3.5( - 4.5, - 2.5)]、躯干脂肪[-4.1( - 4.7, - 3.0)与 - 3.7( - 4.3, - 2.9)kg]、胰岛素[-2.5( - 3.4, - 1.7)与 - 2.4( - 3.3, - 1.4)μU/mL]以及CRP[-0.9( - 1.2, - 0.6)与 - 0.79( - 0.9, - 0.4)mg/L] [校正后]的变化相似(所有P > 0.05)。与25(OH)D < 32 ng/mL的女性相比,随机分配至维生素D组且维生素D充足(即25(OH)D≥32 ng/mL)的女性体重减轻更多[-8.8( - 11.1, - 6.9)与 - 5.6( - 7.2, - 5.0)kg;P = 0.05]、腰围[-6.6( - 9.3, - 4.3)与 - 2.5( - 4.6, - 2.0)cm;P = 0.02]以及体脂百分比[-4.7( - 6.1, - 3.5)与 - 2.6( - 3.9, - 2.2);P = 0.04]。在药丸计数完整(依从性97%)的女性中,维生素D组CRP的平均下降为1.18 mg/mL(46%),而安慰剂组为0.46 mg/mL(25%)(P = 0.03)。

结论

与安慰剂相比,减肥期间补充维生素D3并未增加体重减轻或相关因素;然而,维生素D充足的女性改善更为明显。该试验已在clinicaltrials.gov注册,注册号为NCT01240213。

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