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两种不同剂量维生素D补充剂对胰岛素抵抗型多囊卵巢综合征患者代谢谱的影响:一项随机、双盲、安慰剂对照试验

Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.

作者信息

Foroozanfard Fatemeh, Talebi Maesoomeh, Samimi Mansooreh, Mehrabi Sahar, Badehnoosh Bita, Jamilian Mehri, Maktabi Maryam, Asemi Zatollah

机构信息

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

Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, I. R. Iran.

出版信息

Horm Metab Res. 2017 Aug;49(8):612-617. doi: 10.1055/s-0043-112346. Epub 2017 Jul 5.

Abstract

The current study was conducted to evaluate the effects of 2 different doses of vitamin D supplementation on metabolic profiles of insulin-resistant patients with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 90 insulin-resistant patients with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly allocated into 3 groups to receive either 4 000 IU of vitamin D (n=30) or 1 000 IU of vitamin D (n=30) or placebo (n=30) per day for 12 weeks. Vitamin D supplementation (4 000 IU), compared with vitamin D (1 000 IU) and placebo, led to reduced fasting plasma glucose (-4.3±8.6 vs. -4.7±7.1 and +0.1±6.7 mg/dl, respectively, p=0.02), serum insulin concentrations (-2.7±2.7 vs. -1.4±4.2 and -0.1±4.1 μIU/ml, respectively, p=0.02), and HOMA-IR (-0.6±0.6 vs. -0.4±1.0 and -0.1±0.9, respectively, p=0.02). In addition, we found significant decreases in mean change of serum triglycerides (-10.3±7.3 vs. -3.6±14.5 and +6.9±23.8 mg/dl, respectively, p=0.001), VLDL- (-2.0±1.5 vs. -0.7±2.9 and +1.4±4.8 mg/dl, respectively, p=0.001), total- (-14.0±9.5 vs. -6.2±24.0 and +7.1±29.7 mg/dl, respectively, p=0.002), LDL- (-10.8±8.3 vs. -5.7±21.9 and +6.8±28.2 mg/dl, respectively, p=0.005), and total-/HDL-cholesterol ratio (-0.2±0.3 vs. -0.1±0.6 and +0.2±0.7 mg/dl, respectively, p=0.003) in the high-dose vitamin D group compared with low-dose vitamin D and placebo groups. Overall, vitamin D supplementation at a dosage of 4 000 IU/day for 12 weeks in insulin-resistant patients with PCOS had beneficial effects of glucose metabolism and lipid profiles compared with 1 000 IU/day of vitamin D and placebo groups.

摘要

本研究旨在评估两种不同剂量的维生素D补充剂对多囊卵巢综合征(PCOS)胰岛素抵抗患者代谢谱的影响。这项随机双盲、安慰剂对照试验针对90名符合鹿特丹标准、年龄在18至40岁的PCOS胰岛素抵抗患者进行。参与者被随机分为3组,分别每天接受4000 IU维生素D(n = 30)、1000 IU维生素D(n = 30)或安慰剂(n = 30),持续12周。与维生素D(1000 IU)和安慰剂相比,补充维生素D(4000 IU)可降低空腹血糖(分别为-4.3±8.6 vs. -4.7±7.1和+0.1±6.7mg/dl,p = 0.02)、血清胰岛素浓度(分别为-2.7±2.7 vs. -1.4±4.2和-0.1±4.1μIU/ml,p = 0.02)以及HOMA-IR(分别为-0.6±0.6 vs. -0.4±1.0和-0.1±0.9,p = 0.02)。此外,我们发现高剂量维生素D组的血清甘油三酯平均变化(分别为-10.3±7.3 vs. -3.6±14.5和+6.9±23.8mg/dl,p = 0.001)、极低密度脂蛋白(分别为-2.0±1.5 vs. -0.7±2.9和+1.4±4.8mg/dl,p = 0.001)、总胆固醇(分别为-14.0±9.5 vs. -6.2±24.0和+7.1±29.7mg/dl,p = 0.002)、低密度脂蛋白(分别为-10.8±8.3 vs. -5.7±21.9和+6.8±28.2mg/dl,p = 0.005)以及总胆固醇/高密度脂蛋白胆固醇比值(分别为-0.2±0.3 vs. -0.1±0.6和+0.2±0.7mg/dl,p = 0.003)相较于低剂量维生素D组和安慰剂组均有显著下降。总体而言,与每天1000 IU维生素D组和安慰剂组相比,PCOS胰岛素抵抗患者每天补充4000 IU维生素D持续12周对糖代谢和血脂谱具有有益影响。

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