Felício João Soares, de Oliveira Alana Ferreira, Peixoto Amanda Soares, de Souza Ana Carolina Contente Braga, Abrahão Neto João Felício, de Melo Franciane Trindade Cunha, Carvalho Carolina Tavares, de Lemos Manuela Nascimento, Cavalcante Sávio Diego Nascimento, Resende Fabricio de Souza, Dos Santos Márcia Costa, Motta Ana Regina, Janaú Luísa Corrêa, Yamada Elizabeth Sumi, Felício Karem Miléo
University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Belém, Brazil.
Front Endocrinol (Lausanne). 2017 Aug 14;8:199. doi: 10.3389/fendo.2017.00199. eCollection 2017.
Some studies suggest an association between diabetic kidney disease (DKD) and vitamin D (VD), but there is no data about the effect of high dose of VD on DKD in type 1 diabetes mellitus (T1DM). Our pilot study aims to evaluate albuminuria reduction in patients with T1DM supplemented with high dose of VD.
22 patients received doses of 4,000 and 10,000 IU/day of cholecalciferol for 12 weeks according to patient's previous VD levels. They were submitted to continuous glucose monitoring system, 24 hours ambulatory blood pressure monitoring and urine albumin-to-creatinine ratio before and after VD supplementation.
There was a reduction of DKD prevalence at the end of the study (68 vs 32%; = 0.05), with no changes on insulin doses, glycated hemoglobin, glycemic variability and blood pressure values. A correlation between percentage variation of VD levels (ΔVD) and albuminuria at the end of the study was presented ( = -0.5; < 0.05). Among T1DM patients with DKD at the beginning of the study, 8/13 (62%) had their DKD stage improved, while the other five ones (38%) showed no changes ( < 0.05).
Our pilot study suggests an association between VD high dose supplementation, lower prevalence and improvement in stages of DKD in T1DM.
一些研究表明糖尿病肾病（DKD）与维生素D（VD）之间存在关联，但尚无关于高剂量VD对1型糖尿病（T1DM）患者DKD影响的数据。我们的初步研究旨在评估补充高剂量VD的T1DM患者蛋白尿的减少情况。
根据患者先前的VD水平，22例患者接受了4000和10000国际单位/天的胆钙化醇治疗，为期12周。在补充VD前后，他们接受了连续血糖监测系统、24小时动态血压监测以及尿白蛋白与肌酐比值检测。
研究结束时DKD患病率有所降低（68%对32%；P = 0.05），胰岛素剂量、糖化血红蛋白、血糖变异性和血压值无变化。研究结束时呈现出VD水平变化百分比（ΔVD）与蛋白尿之间的相关性（r = -0.5；P < 0.05）。在研究开始时患有DKD的T1DM患者中，8/13（62%）的DKD分期得到改善，而其他5例（38%）无变化（P < 0.05）。
我们的初步研究表明，高剂量补充VD与T1DM患者DKD患病率降低及分期改善之间存在关联。
