Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Division of Endocrinology, University of Toronto, Toronto, ON, Canada.
Sci Rep. 2017 Jan 13;7:40751. doi: 10.1038/srep40751.
To investigate the effects of micronutrients on blood pressure (BP) in patients with type 2 diabetes through a systematic review and meta-analysis, randomized clinical trials (RCTs) of the effects of individual micronutrients on BP in patients with type 2 diabetes were searched in the Medline, Embase, Cochrane, and Clinical Trials.gov databases through April 2016. From the 28,164 studies, 11 RCTs (13 interventions, 723 patients, 54% males) with 3 to 52 weeks of follow-up were classified according to the type of micronutrient intervention: sodium (n = 1), vitamin C (n = 2), vitamin D (n = 7), and magnesium (n = 1). The available data enabled us to perform meta-analyses of vitamins C and D. Vitamin C reduced diastolic BP [WMD -2.88 mmHg (95%CI -5.31, -0.46; P = 0.020)] but not systolic BP [WMD -3.93 mmHg (95%CI -14.78, 6.92; P = 0.478)]. Vitamin D caused a reduction of 4.56 mmHg (WMD; 95%CI -7.65, -1.47; P = 0.004) for systolic BP and 2.44 mm Hg (WMD; 95%CI -3.49, -1.39; P < 0.001) for diastolic BP. In conclusion, vitamin D and possibly vitamin C have beneficial effects on BP in patients with type 2 diabetes. These interventions might represent a novel approach to the treatment of hypertension in these patients.
为了通过系统评价和荟萃分析研究微量营养素对 2 型糖尿病患者血压(BP)的影响,我们在 Medline、Embase、Cochrane 和 ClinicalTrials.gov 数据库中检索了 2016 年 4 月之前关于 2 型糖尿病患者个体微量营养素对 BP 影响的随机对照试验(RCT)。从 28164 项研究中,根据微量营养素干预类型将 11 项 RCT(13 项干预措施,723 名患者,54%为男性)[3 至 52 周随访]分为以下几类:钠(n=1)、维生素 C(n=2)、维生素 D(n=7)和镁(n=1)。可利用的数据使我们能够对维生素 C 和 D 进行荟萃分析。维生素 C 降低舒张压[WMD-2.88mmHg(95%CI-5.31,-0.46;P=0.020)],但不降低收缩压[WMD-3.93mmHg(95%CI-14.78,6.92;P=0.478)]。维生素 D 使收缩压降低 4.56mmHg(WMD;95%CI-7.65,-1.47;P=0.004),舒张压降低 2.44mmHg(WMD;95%CI-3.49,-1.39;P<0.001)。总之,维生素 D 和可能的维生素 C 对 2 型糖尿病患者的血压有有益影响。这些干预措施可能代表了治疗这些患者高血压的一种新方法。