Department of Nutrition, School of Public Health, Colorectal Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Colorectal Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2017 Dec;36(6):1490-1497. doi: 10.1016/j.clnu.2016.09.020. Epub 2016 Sep 28.
BACKGROUND & AIMS: Despite evidence for beneficial effects of vitamin D, to our knowledge, no study has compared the effects of calcium supplementation with vitamin D on non-alcoholic fatty liver disease (NAFLD) regression during a hypo-energetic program. We compared the effect of the vitamin D supplementation with and without calcium on anthropometric measures and biochemical parameters in NAFLD patients during a weight-loss program.
A 12-week, randomized, controlled, double-blind trial was conducted in 120 NAFLD patients randomly assigned to receive 25 μg calcitriol (n = 37), 500 mg calcium carbonate + 25 μg calcitriol (n = 37), or placebo (n = 36) every day with their lunch meals while following a weight-loss program.
Weight, BMI and fat mass reduction were significant in each group after 12 wk of intervention (p < 0.001), but differences among the groups was not significant after 12 wk of the study, adjusted to the baseline measurements. Significant reduction in fasting plasma glucose (FPG), insulin, insulin resistance (by HOMA-IR) and TG concentrations and an increase in HDL.C was seen over the 12 wk of study in each group (p < 0.001). Adjusting to the baseline measurements, there was significant difference in FPG (p < 0.001), HOMA-IR (p < 0.001), serum insulin (p = 0.01), TG (p = 0.01) and HDL.C (p < 0.001) among the groups after 12 wk of the study. The calcium plus calcitriol group showed a significant decrease in ALT and FPG and increase in HDL.C level compared with the calcitriol group, adjusted to the baseline measures (p < 0.001).
Our results suggest that calcium plus calcitriol supplementation for 12 weeks may be potentially effective for biochemical parameters in NAFLD patients. Further additional larger controlled trials are needed to confirm these findings.
Registered under ClinicalTrials.gov Identifier no. IRCT201408312709N29.
尽管有证据表明维生素 D 有益,但据我们所知,尚无研究比较钙补充剂与维生素 D 对低能量方案中非酒精性脂肪性肝病 (NAFLD) 消退的影响。我们比较了维生素 D 补充剂与钙补充剂对减肥方案中 NAFLD 患者的人体测量指标和生化参数的影响。
对 120 例 NAFLD 患者进行了为期 12 周的随机、对照、双盲试验,将其随机分为三组:每天午餐时分别服用 25μg 骨化三醇(n=37)、500mg 碳酸钙+25μg 骨化三醇(n=37)或安慰剂(n=36),同时进行减肥计划。
12 周干预后,每组体重、BMI 和脂肪量均显著降低(p<0.001),但研究结束时,调整基线测量值后,各组之间无差异。12 周研究期间,各组空腹血糖(FPG)、胰岛素、胰岛素抵抗(HOMA-IR)和 TG 浓度显著降低,HDL.C 浓度升高(p<0.001)。调整基线测量值后,研究结束时各组 FPG(p<0.001)、HOMA-IR(p<0.001)、血清胰岛素(p=0.01)、TG(p=0.01)和 HDL.C(p<0.001)均有显著差异。与骨化三醇组相比,碳酸钙加骨化三醇组的 ALT 和 FPG 降低,HDL.C 水平升高,调整基线测量值后差异有统计学意义(p<0.001)。
我们的结果表明,钙加骨化三醇补充剂治疗 12 周可能对 NAFLD 患者的生化参数有效。需要进一步进行更大规模的对照试验以证实这些发现。
ClinicalTrials.gov 标识符:IRCT201408312709N29。