Shih Erin M, Mittelman Steven, Pitukcheewanont Pisit, Azen Colleen G, Monzavi Roshanak
Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, 90027, USA.
Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA.
Pediatr Diabetes. 2016 Feb;17(1):36-43. doi: 10.1111/pedi.12238. Epub 2014 Dec 18.
Little is known about the relationship between vitamin D deficiency and adolescents with type 1 diabetes. On the basis of adult studies showing that vitamin D improves insulin sensitivity and decreases inflammatory cytokines linked to microvascular complications, we hypothesized that treating vitamin D deficiency in adolescents with type 1 diabetes would improve glycemia and reduce inflammatory markers.
This was a randomized, prospective, crossover study of 25 adolescents with type 1 diabetes for at least a year (aged: 13-21 yr; 62% female; 62% Hispanic) and vitamin D deficiency (25-OH vitamin D ≤30 ng/mL). Subjects received vitamin D3 (20 000 IU/week) for 6 months, either immediately or after 6 months of observation.
At baseline, 63% of subjects screened were vitamin D deficient and randomized. Interleukin-6 (IL-6) was significantly higher in the vitamin D deficient group compared with the sufficient group (medians: 0.36 vs. 0.18) (p = 0.026), whereas neither C-reactive protein (CRP) nor tumor necrosis factor-α (TNF-α) differed. Vitamin D treatment increased serum levels of 25-OH vitamin D from 22 ± 5.3 to 34.3 ± 12.1 ng/mL (p < 0.01). However, treatment did not affect glycated hemoglobin (HbA1c), insulin dosage, CRP, interleukin-6 (IL-6), or TNF-α.
Vitamin D deficiency is prevalent in the adolescent type 1 diabetes population, and could be associated with changes in inflammatory markers. However, vitamin D repletion over 6 months did not affect glycemia or markers of inflammation in our study, highlighting the need for additional research to validate these findings.
维生素D缺乏与1型糖尿病青少年之间的关系鲜为人知。基于成人研究表明维生素D可改善胰岛素敏感性并降低与微血管并发症相关的炎性细胞因子，我们推测治疗1型糖尿病青少年的维生素D缺乏会改善血糖并降低炎症标志物。
这是一项针对25名患有1型糖尿病至少一年的青少年（年龄：13 - 21岁；62%为女性；62%为西班牙裔）且维生素D缺乏（25 - 羟基维生素D≤30 ng/mL）的随机、前瞻性、交叉研究。受试者立即或在观察6个月后接受6个月的维生素D3（20000 IU/周）治疗。
在基线时，63%经筛查的受试者维生素D缺乏并被随机分组。与充足组相比，维生素D缺乏组的白细胞介素 - 6（IL - 6）显著更高（中位数：0.36对0.18）（p = 0.026），而C反应蛋白（CRP）和肿瘤坏死因子 - α（TNF - α）均无差异。维生素D治疗使血清25 - 羟基维生素D水平从22±5.3 ng/mL升至34.3±12.1 ng/mL（p < 0.01）。然而，治疗并未影响糖化血红蛋白（HbA1c）、胰岛素剂量、CRP、白细胞介素 - 6（IL - 6）或肿瘤坏死因子 - α（TNF - α）。
维生素D缺乏在1型糖尿病青少年人群中普遍存在，且可能与炎症标志物变化有关。然而，在我们的研究中，6个月的维生素D补充并未影响血糖或炎症标志物，这凸显了需要进一步研究来验证这些发现。
