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维生素D与ω-3脂肪酸联合补充对妊娠期糖尿病患者血糖控制及血脂浓度的影响。

The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes.

作者信息

Jamilian Mehri, Samimi Mansooreh, Ebrahimi Faraneh Afshar, Hashemi Teibeh, Taghizadeh Mohsen, Razavi Maryamalsadat, Sanami Marzieh, Asemi Zatollah

机构信息

Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.

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

出版信息

J Clin Lipidol. 2017 Mar-Apr;11(2):459-468. doi: 10.1016/j.jacl.2017.01.011. Epub 2017 Feb 2.

Abstract

OBJECTIVE

This study was performed to evaluate the effects of vitamin D and omega-3 fatty acids co-supplementation on glucose metabolism and lipid concentrations in gestational diabetes (GDM) patients.

METHODS

This randomized double-blind placebo-controlled clinical trial was done among 140 GDM patients. Participants were randomly divided into 4 groups to receive: (1) 1000 mg omega-3 fatty acids containing 360 mg eicosapentaenoic acid and 240 mg docosahexaenoic acid (DHA) twice a day + vitamin D placebo (n = 35); (2) 50,000 IU vitamin D every 2 weeks + omega-3 fatty acids placebo (n = 35); (3) 50,000 IU vitamin D every 2 weeks + 1000 mg omega-3 fatty acids twice a day (n = 35), and (4) vitamin D placebo + omega-3 fatty acids placebo (n = 35) for 6 weeks.

RESULTS

After 6 weeks of intervention, patients who received combined vitamin D and omega-3 fatty acids supplements compared with vitamin D, omega-3 fatty acids, and placebo had significantly decreased fasting plasma glucose (-7.3 ± 7.8, -6.9 ± 6.6, -4.0 ± 2.5, and +1.0 ± 11.4 mg/dL, respectively, P < .001), serum insulin levels (-1.9 ± 1.9, -1.3 ± 6.3, -0.4 ± 6.3, and +2.6 ± 6.5 μIU/mL, respectively, P = .005), homeostatic model of assessment for insulin resistance (-0.7 ± 0.6, -0.5 ± 1.4, -0.2 ± 1.5, and +0.6 ± 1.5, respectively, P < .001) and increased quantitative insulin sensitivity check index (+0.01 ± 0.01, +0.008 ± 0.02, +0.002 ± 0.02, and -0.005 ± 0.02, respectively, P = .001). In addition, changes in serum triglycerides (-8.2 ± 41.0, +7.6 ± 31.5, +3.6 ± 29.9, and +20.1 ± 29.6 mg/dL, respectively, P = .006) and very low-density lipoprotein cholesterol (-1.6 ± 8.2, +1.5 ± 6.3, +0.8 ± 6.0, and +4.0 ± 5.9 mg/dL, respectively, P = .006) in the vitamin D plus omega-3 fatty acids group were significantly different from the changes in these indicators in the vitamin D, omega-3 fatty acids, and placebo groups.

CONCLUSION

Overall, vitamin D and omega-3 fatty acids co-supplementation for 6 weeks among GDM patients had beneficial effects on fasting plasma glucose, serum insulin levels, homeostatic model of assessment for insulin resistance, quantitative insulin sensitivity check index, serum triglycerides, and very low-density lipoprotein cholesterol levels.

摘要

目的

本研究旨在评估联合补充维生素D和ω-3脂肪酸对妊娠期糖尿病(GDM)患者糖代谢和血脂浓度的影响。

方法

本随机双盲安慰剂对照临床试验纳入了140例GDM患者。参与者被随机分为4组,分别接受:(1)每天2次,每次1000mg含360mg二十碳五烯酸和240mg二十二碳六烯酸(DHA)的ω-3脂肪酸 + 维生素D安慰剂(n = 35);(2)每2周50,000IU维生素D + ω-3脂肪酸安慰剂(n = 35);(3)每2周50,000IU维生素D + 每天2次1000mg ω-3脂肪酸(n = 35);(4)维生素D安慰剂 + ω-3脂肪酸安慰剂(n = 35),持续6周。

结果

干预6周后,联合补充维生素D和ω-3脂肪酸的患者与单独补充维生素D、ω-3脂肪酸及安慰剂的患者相比,空腹血糖显著降低(分别为-7.3±7.8、-6.9±6.6、-4.0±2.5和+1.0±11.4mg/dL,P <.001),血清胰岛素水平降低(分别为-1.9±1.9、-1.3±6.3、-0.4±6.3和+2.6±6.5μIU/mL,P =.005),胰岛素抵抗稳态模型评估降低(分别为-0.7±0.6、-0.5±1.4、-0.2±1.5和+0.6±1.5,P <.001),定量胰岛素敏感性检查指数升高(分别为+0.01±0.01、+0.008±0.02、+0.002±0.02和-0.005±0.02,P =.001)。此外,维生素D加ω-3脂肪酸组血清甘油三酯(分别为-8.2±41.0、+7.6±31.5、+3.6±29.9和+20.1±29.6mg/dL,P =.006)和极低密度脂蛋白胆固醇(分别为-1.6±8.2、+1.5±6.3、+0.8±6.0和+4.0±5.9mg/dL,P =.006)的变化与维生素D组、ω-3脂肪酸组和安慰剂组这些指标的变化有显著差异。

结论

总体而言,GDM患者联合补充维生素D和ω-3脂肪酸6周对空腹血糖、血清胰岛素水平、胰岛素抵抗稳态模型评估、定量胰岛素敏感性检查指数、血清甘油三酯和极低密度脂蛋白胆固醇水平有有益影响。

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