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子宫内膜增生患者补充维生素D的临床及代谢反应:一项随机、双盲、安慰剂对照试验

Clinical and Metabolic Response to Vitamin D Supplementation in Endometrial Hyperplasia: a Randomized, Double-Blind, Placebo-Controlled Trial.

作者信息

Tabassi Zohreh, Bagheri Sedigheh, Samimi Mansooreh, Gilasi Hamid Reza, Bahmani Fereshteh, Chamani Maryam, Asemi Zatollah

机构信息

Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran.

Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

Horm Cancer. 2017 Jun;8(3):185-195. doi: 10.1007/s12672-017-0290-9. Epub 2017 Mar 10.

Abstract

There was inconsistent evidence showing that vitamin D intake may be associated with reduced cancer risk due to optimized metabolic profile and reduced oxidative stress. However, we are not aware of any study evaluating the effects of vitamin D supplementation on clinical response and metabolic status of patients with endometrial hyperplasia (EH). This research was done to evaluate the effects of vitamin D supplementation on clinical response and metabolic status of patients with EH. This randomized, double-blind, placebo-controlled trial was conducted among 60 women diagnosed with EH. EH diagnosis was made based on specific diagnostic procedures of biopsy. Participants were randomly assigned into two groups to intake either 50,000 IU vitamin D3 supplements (n = 30) or placebo (n = 30) every 2 weeks for 12 weeks. After the 12-week intervention, compared with the placebo, vitamin D supplementation increased serum-25(OH) vitamin D levels (+12.0 ± 10.4 vs. +1.9 ± 7.1 ng/mL, P < 0.001). In addition, vitamin D administration was associated with significant decreases in fasting plasma glucose (FPG) (-1.6 ± 7.0 vs. +2.1 ± 6.1 mg/dL, P = 0.03), serum insulin levels (-0.8 ± 1.9 vs. +1.1 ± 3.5 μIU/mL, P = 0.01), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.2 ± 0.6 vs. +0.3 ± 0.8, P = 0.01), and a significant increase in the quantitative insulin sensitivity check index (QUICKI) (+0.003 ± 0.01 vs. -0.01 ± 0.02, P = 0.02) compared with the placebo. Additionally, a significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) (-1.9 ± 2.8 vs. -0.003 ± 2.0 μg/mL, P = 0.003) and a significant rise in plasma total antioxidant capacity (TAC) values (+62.5 ± 53.5 vs. +7.5 ± 34.1 mmol/L, P < 0.001) were observed following supplementation with vitamin D compared with the placebo. In conclusion, vitamin D3 supplementation for 12 weeks among women with EH had beneficial effects on glucose metabolism, serum hs-CRP, and plasma TAC concentrations. In addition, vitamin D may have played an indirect role in reducing complications of EH due to its effect on improved glycemic control, hs-CRP, and TAC concentrations.

摘要

有不一致的证据表明,由于优化的代谢谱和降低的氧化应激,维生素D摄入可能与降低癌症风险有关。然而,我们不知道有任何研究评估维生素D补充剂对子宫内膜增生(EH)患者临床反应和代谢状态的影响。本研究旨在评估维生素D补充剂对EH患者临床反应和代谢状态的影响。这项随机、双盲、安慰剂对照试验在60名被诊断为EH的女性中进行。EH诊断基于活检的特定诊断程序。参与者被随机分为两组,每2周分别摄入50000IU维生素D3补充剂(n = 30)或安慰剂(n = 30),持续12周。12周干预后,与安慰剂相比,补充维生素D可提高血清25(OH)维生素D水平(+12.0±10.4 vs. +1.9±7.1 ng/mL,P < 0.001)。此外,与安慰剂相比,给予维生素D可使空腹血糖(FPG)显著降低(-1.6±7.0 vs. +2.1±6.1 mg/dL,P = 0.03)、血清胰岛素水平显著降低(-0.8±1.9 vs. +1.1±3.5 μIU/mL,P = 0.01)、稳态模型评估胰岛素抵抗(HOMA-IR)显著降低(-0.2±0.6 vs. +0.3±0.8,P = 0.01),定量胰岛素敏感性检查指数(QUICKI)显著升高(+0.003±0.01 vs. -0.01±0.02,P = 0.02)。此外,与安慰剂相比,补充维生素D后血清高敏C反应蛋白(hs-CRP)显著降低(-1.9±2.8 vs. -0.003±2.0 μg/mL,P = 0.003),血浆总抗氧化能力(TAC)值显著升高(+62.5±53.5 vs. +7.5±34.1 mmol/L,P < 0.001)。总之,EH女性补充12周维生素D3对糖代谢、血清hs-CRP和血浆TAC浓度有有益影响。此外,维生素D可能因其对改善血糖控制、hs-CRP和TAC浓度的作用,在降低EH并发症方面发挥了间接作用。

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