Lee Clare J, Iyer Geetha, Liu Yang, Kalyani Rita R, Bamba N'Dama, Ligon Colin B, Varma Sanskriti, Mathioudakis Nestoras
Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, USA.
The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Diabetes Complications. 2017 Jul;31(7):1115-1126. doi: 10.1016/j.jdiacomp.2017.04.019. Epub 2017 Apr 21.
We aimed to assess whether vitamin D supplementation improves glucose metabolism in adults with type 2 diabetes.
PubMed and Cochrane database were searched up to July 1st 2016 for randomized controlled trials that assessed the relationship between vitamin D supplementation and glucose metabolism (change in hemoglobin A1C (HbA1C) and fasting blood glucose (FBG)) among adults with type 2 diabetes.
Twenty nine trials (3324 participants) were included in the systematic review. Among 22 studies included in the meta-analysis, 19 reported HbA1C, 16 reported FBG outcomes and 15 were deemed poor quality. There was a modest reduction in HbA1C (-0.32% [-0.53 to -0.10], I=91.9%) compared to placebo after vitamin D supplementation but no effect on FBG (-2.33mg/dl [-6.62 to 1.95], I=59.2%). In studies achieving repletion of vitamin D deficiency (n=7), there were greater mean reductions in HbA1C (-0.45%, [-1.09 to 0.20]) and FBG (-7.64mg/dl [-16.25 to 0.97]) although not significant.
We found a modest reduction of HbA1C after vitamin D treatment in adults with type 2 diabetes albeit with substantial heterogeneity between studies and no difference in FBG. Larger studies are needed to further evaluate the glycemic effects of vitamin D treatment especially in patients with vitamin D deficiency.
我们旨在评估补充维生素D是否能改善2型糖尿病成人患者的糖代谢。
检索截至2016年7月1日的PubMed和Cochrane数据库，查找评估2型糖尿病成人患者补充维生素D与糖代谢（糖化血红蛋白（HbA1C）和空腹血糖（FBG）变化）之间关系的随机对照试验。
系统评价纳入了29项试验（3324名参与者）。在纳入荟萃分析的22项研究中，19项报告了HbA1C结果，16项报告了FBG结果，15项被认为质量较差。补充维生素D后，与安慰剂相比，HbA1C有适度降低（-0.32%[-0.53至-0.10]，I=91.9%），但对FBG无影响（-2.33mg/dl[-6.62至1.95]，I=59.2%）。在实现维生素D缺乏纠正的研究中（n=7），HbA1C（-0.45%，[-1.09至0.20]）和FBG（-7.64mg/dl[-16.25至0.97]）的平均降低幅度更大，尽管不显著。
我们发现2型糖尿病成人患者维生素D治疗后HbA1C有适度降低，尽管研究间存在较大异质性，且FBG无差异。需要更大规模的研究来进一步评估维生素D治疗对血糖的影响，尤其是在维生素D缺乏的患者中。
