Vahedpoor Zahra, Jamilian Mehri, Bahmani Fereshteh, Aghadavod Esmat, Karamali Maryam, Kashanian Maryam, Asemi Zatollah
Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R, Iran.
Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Horm Cancer. 2017 Feb;8(1):58-67. doi: 10.1007/s12672-016-0278-x. Epub 2017 Jan 3.
We are not aware of any study examining the effects of long term vitamin D administration on regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This study was performed to evaluate the effects of long-term vitamin D administration on regression and metabolic status of patients with CIN1. This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1. CIN1 diagnosis was performed based on specific diagnostic procedures of biopsy, pathological diagnosis, and colposcopy. Patients were randomly allocated into two groups to take 50,000 IU vitamin D3 supplements (n = 29) or placebo (n = 29) every 2 weeks for 6 months. Fasting blood samples were taken at the beginning of the study and end-of-trial to measure related markers. After 6 months of vitamin D administration, greater percentage of women in the vitamin D group had regressed CIN1 (84.6 vs. 53.8%, P = 0.01) than those in the placebo group. Long-term vitamin D supplementation increased serum-25(OH) vitamin D levels in the intervention group compared to the placebo group (+12.3 ± 11.4 vs. -0.1 ± 3.7 ng/mL, P < 0.001). In addition, vitamin D intake led to significant decreases in serum insulin levels (-5.3 ± 7.3 vs. +2.4 ± 5.9 μIU/mL, P < 0.001), homeostasis model of assessment-insulin resistance (-1.2 ± 1.6 vs. +0.5 ± 1.2, P < 0.001), homeostatic model assessment-Beta cell function (P = 0.005) and a significant elevation in quantitative insulin sensitivity check index (+0.03 ± 0.04 vs. -0.007 ± 0.02, P < 0.001) compared with the placebo group. Additionally, significant increases in plasma nitric oxide (NO) (+15.5 ± 10.3 vs. +4.0 ± 13.4 μmol/L, P = 0.001), total antioxidant capacity (TAC) (P = 0.04), total glutathione (GSH) (+11.8 ± 153.5 vs. -294.2 ± 595.1 μmol/L, P = 0.01) and a significant reduction in plasma malondialdehyde (MDA) levels (-0.8 ± 1.0 vs. -0.03 ± 1.4 μmol/L, P = 0.03) were observed following the administration of vitamin D supplements compared with the placebo group. In conclusion, vitamin D3 administration for 6 months among women with CIN1 resulted in its regression and had beneficial effects on markers of insulin metabolism, plasma NO, TAC, GSH and MDA levels. Clinical trial registration number www.irct.ir : IRCT201412065623N30.
我们尚未发现有任何研究探讨长期给予维生素D对1级宫颈上皮内瘤变（CIN1）患者病情消退及代谢状况的影响。本研究旨在评估长期给予维生素D对CIN1患者病情消退及代谢状况的影响。这项随机、双盲、安慰剂对照试验在58例被诊断为CIN1的女性中进行。CIN1的诊断基于活检、病理诊断和阴道镜检查的特定诊断程序。患者被随机分为两组，每2周服用50,000 IU维生素D3补充剂（n = 29）或安慰剂（n = 29），持续6个月。在研究开始时和试验结束时采集空腹血样以测量相关指标。给予维生素D 6个月后，维生素D组病情消退的女性比例（84.6%对53.8%，P = 0.01）高于安慰剂组。与安慰剂组相比，干预组长期补充维生素D可使血清25(OH)维生素D水平升高（+12.3±11.4对 -0.1±3.7 ng/mL，P < 0.001）。此外，与安慰剂组相比，摄入维生素D导致血清胰岛素水平显著降低（-5.3±7.3对 +2.4±5.9 μIU/mL，P < 0.001）、稳态模型评估-胰岛素抵抗降低（-1.2±1.6对 +0.5±1.2，P < 0.001）、稳态模型评估-β细胞功能降低（P = 0.005）以及定量胰岛素敏感性检查指数显著升高（+0.03±0.04对 -0.007±0.02，P < 0.001）。此外，与安慰剂组相比，给予维生素D补充剂后，血浆一氧化氮（NO）显著升高（+15.5±10.3对 +4.0±13.4 μmol/L，P = 0.001）、总抗氧化能力（TAC）升高（P = 0.04）、总谷胱甘肽（GSH）升高（+11.8±153.5对 -294.2±595.1 μmol/L，P = 0.01），且血浆丙二醛（MDA）水平显著降低（-0.8±1.0对 -0.03±1.4 μmol/L，P = 0.03）。总之，对CIN1女性给予维生素D3 6个月可使其病情消退，并对胰岛素代谢指标、血浆NO水平、TAC、GSH和MDA水平产生有益影响。临床试验注册号：www.irct.ir ：IRCT201412065623N30 。
