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维生素D能否改善非酒精性脂肪性肝病成人患者的肝酶、氧化应激和炎症生物标志物?一项随机临床试验。

Does vitamin D improve liver enzymes, oxidative stress, and inflammatory biomarkers in adults with non-alcoholic fatty liver disease? A randomized clinical trial.

作者信息

Sharifi Nasrin, Amani Reza, Hajiani Eskandar, Cheraghian Bahman

机构信息

Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,

出版信息

Endocrine. 2014 Sep;47(1):70-80. doi: 10.1007/s12020-014-0336-5. Epub 2014 Jun 27.

Abstract

The aim of this study was to investigate the effects of vitamin D supplementation on serum aminotransferases, insulin resistance, oxidative stress, and inflammatory biomarkers in adult patients with non-alcoholic fatty liver disease (NAFLD). Fifty-three patients with NAFLD were enrolled in a parallel, double-blind, placebo-controlled study. The patients were randomly allocated to receive either one oral pearl consisting of 50,000 IU vitamin D3 (n = 27) or a placebo (n = 26), every 14 days for 4 months. Serum aminotransferases, high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor α, malondialdehyde (MDA), total antioxidant capacity, transforming growth factor β1, as well as grade of hepatic steatosis and homeostasis model assessment of insulin resistance were assessed pre- and post-intervention. In patients who received vitamin D supplement compared to the controls, the median of serum 25(OH)D3 significantly increased (16.2 vs. 1.6 ng/ml, P < 0.001). This increase accompanied by significant decrease in serum MDA (-2.09 vs. -1.23 ng/ml, P = 0.03) and near significant changes in serum hs-CRP (-0.25 vs. 0.22 mg/l, P = 0.06). These between-group differences remained significant even after controlling for baseline covariates. Other variables showed no significant changes. Improved vitamin D status led to amelioration in serum hs-CRP and MDA in patients with NAFLD. This might be considered as an adjunctive therapy to attenuate systemic inflammation and lipid peroxidation alongside other treatments for NAFLD patients.

摘要

本研究旨在探讨补充维生素D对非酒精性脂肪性肝病(NAFLD)成年患者血清转氨酶、胰岛素抵抗、氧化应激和炎症生物标志物的影响。53例NAFLD患者参与了一项平行、双盲、安慰剂对照研究。患者被随机分配,每14天接受一粒含50,000 IU维生素D3的口服胶囊(n = 27)或安慰剂(n = 26),共4个月。在干预前后评估血清转氨酶、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α、丙二醛(MDA)、总抗氧化能力、转化生长因子β1,以及肝脂肪变性分级和胰岛素抵抗的稳态模型评估。与对照组相比,接受维生素D补充的患者血清25(OH)D3中位数显著升高(16.2对1.6 ng/ml,P < 0.001)。这种升高伴随着血清MDA的显著降低(-2.09对-1.23 ng/ml,P = 0.03)和血清hs-CRP的接近显著变化(-0.25对0.22 mg/l,P = 0.06)。即使在控制基线协变量后,这些组间差异仍然显著。其他变量无显著变化。改善维生素D状态可使NAFLD患者的血清hs-CRP和MDA得到改善。这可被视为一种辅助治疗,与NAFLD患者的其他治疗一起减轻全身炎症和脂质过氧化。

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