Shah Sejal, Wilson Darrell M, Bachrach Laura K
Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California.
Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California.
J Adolesc Health. 2015 Jul;57(1):19-23. doi: 10.1016/j.jadohealth.2015.02.006. Epub 2015 Apr 11.
Vitamin D deficiency and cardiometabolic risk factors are common in obese adolescents. Observational studies demonstrate an inverse relationship among serum 25-hydroxyvitamin D (25OHD) and obesity, insulin resistance, and inflammatory cytokines. This pilot study explores if vitamin D supplementation could reduce serum concentrations of inflammatory cytokines (interleukin [IL] 6, IL-10, tumor necrosis factor α), adiponectin, lipids, hemoglobin A1C, and high-sensitivity C-reactive protein (hs-CRP). A secondary aim was to determine the associations between baseline serum 25OHD concentrations and body mass index (BMI), hs-CRP, inflammatory cytokines, and lipids.
Overweight and obese adolescents enrolled in this 24-week, randomized, double-blind study were given 150,000 IU ergocalciferol or placebo at baseline and 12 weeks. Outcome measurements included serum 25OHD, inflammatory cytokines, adiponectin, hs-CRP, lipids, hemoglobin A1C, and BMI at baseline, 12, and 24 weeks.
Of 40 participants, 31 (78%) completed the study. Mean ± standard error 25OHD levels were similar in vitamin D and placebo groups at baseline (19.6 ± 5.3 vs. 25.8 ± 10.8 ng/mL) and 24 weeks (20.1 ± 3.4 vs. 24.6 ± 8.4 ng/mL). Inflammatory and cardiovascular markers were not significantly different between groups at 24 weeks. Serum 25OHD at baseline was associated with BMI (r = -.44 [95% confidence interval, -.66 to -.15]) but not with other outcome measures.
Supplementation with vitamin D at 150,000 IU every 3 months failed to increase serum 25OHD or alter inflammatory markers and lipids in overweight and obese youth. Further studies are needed to establish the dose of vitamin D required to increase 25OHD and determine potential effects on metabolic risk factors in obese teens.
维生素D缺乏和心血管代谢危险因素在肥胖青少年中很常见。观察性研究表明血清25-羟维生素D(25OHD)与肥胖、胰岛素抵抗及炎性细胞因子之间存在负相关关系。这项初步研究探讨补充维生素D是否能降低炎性细胞因子(白细胞介素[IL]6、IL-10、肿瘤坏死因子α)、脂联素、血脂、糖化血红蛋白A1C及高敏C反应蛋白(hs-CRP)的血清浓度。次要目的是确定基线血清25OHD浓度与体重指数(BMI)、hs-CRP、炎性细胞因子及血脂之间的关联。
参与这项为期24周的随机双盲研究的超重和肥胖青少年在基线及12周时分别给予150,000 IU麦角钙化醇或安慰剂。结局指标包括基线、12周及24周时的血清25OHD、炎性细胞因子、脂联素、hs-CRP、血脂、糖化血红蛋白A1C及BMI。
40名参与者中,31名(78%)完成了研究。维生素D组和安慰剂组在基线时(19.6±5.3对25.8±10.8 ng/mL)及24周时(20.1±3.4对24.6±8.4 ng/mL)的平均±标准误25OHD水平相似。24周时两组间炎性和心血管标志物无显著差异。基线时血清25OHD与BMI相关(r = -0.44[95%置信区间,-0.66至-0.15]),但与其他结局指标无关。
每3个月补充150,000 IU维生素D未能提高超重和肥胖青少年的血清25OHD水平,也未改变炎性标志物及血脂。需要进一步研究以确定提高25OHD所需的维生素D剂量,并确定其对肥胖青少年代谢危险因素的潜在影响。