补充大剂量维生素 D 对糖尿病前期患者骨密度的影响。

The effect of high-dose vitamin D supplementation on bone mineral density in subjects with prediabetes.

机构信息

Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.

Division of Internal Medicine, University Hospital of North Norway, 9038, Tromsø, Norway.

出版信息

Osteoporos Int. 2018 Jan;29(1):171-180. doi: 10.1007/s00198-017-4222-x. Epub 2017 Sep 18.

Abstract

UNLABELLED

The rationale of this study was to determine the effect of high-dose vitamin D supplementation on bone mineral density (BMD). Prediabetic males given vitamin D had significantly less reduction in BMD at the femoral neck compared to the controls. The clinical implications of our findings require further investigation.

INTRODUCTION

Type 2 diabetes mellitus is associated with increased fracture risk, and recent studies show crosstalk between bone and glucose metabolism. Few studies have investigated the effect of vitamin D supplementation on the bone without additional calcium. In the present study, we aimed to determine whether a high dose of vitamin D could improve bone mass density (BMD) in prediabetic subjects.

METHODS

The current study was conducted as a secondary research on a previously performed trial, in which 511 subjects with prediabetes were randomized to vitamin D (20,000 IU per week) versus placebo for 5 years. BMD was measured using dual-energy X-ray absorptiometry (DEXA).

RESULTS

Two hundred and fifty-six subjects were randomized to vitamin D and 255 to placebo. Mean baseline serum 25-hydroxyvitamin D (25(OH)D) level was 60 nmol/L. Two hundred and two and 214 in the vitamin D and placebo groups, respectively, completed BMD measurements, whereas one in each group was excluded due to use of bisphosphonates. Males given vitamin D had significantly less reduction in BMD at the femoral neck measurement site compared to the controls (0.000 versus - 0.010 g/cm, p = 0.008). No significant differences between intervention groups were seen at the total hip measurement site, regarding both males and females.

CONCLUSIONS

Vitamin D supplementation alone may be beneficial in males with prediabetes, but confirmatory studies are needed.

摘要

目的

本研究旨在探讨大剂量维生素 D 补充对骨密度(BMD)的影响。与对照组相比,给予维生素 D 的糖尿病前期男性,其股骨颈 BMD 降低幅度显著较小。我们的研究结果具有重要的临床意义,需要进一步研究。

引言

2 型糖尿病与骨折风险增加相关,最近的研究表明骨与葡萄糖代谢之间存在相互作用。很少有研究调查维生素 D 补充对无额外钙补充的骨骼的影响。在本研究中,我们旨在确定高剂量维生素 D 是否可以改善糖尿病前期患者的骨量密度(BMD)。

方法

本研究是对先前进行的一项试验的二次研究,其中将 511 例糖尿病前期患者随机分为维生素 D(每周 20,000 IU)组和安慰剂组,进行为期 5 年的治疗。使用双能 X 射线吸收法(DEXA)测量 BMD。

结果

256 例患者被随机分配至维生素 D 组,255 例患者被分配至安慰剂组。基线时血清 25-羟维生素 D(25(OH)D)水平的中位数为 60 nmol/L。分别有 202 名和 214 名患者在维生素 D 组和安慰剂组完成了 BMD 测量,而每组各有 1 名患者因使用双膦酸盐而被排除。与对照组相比,给予维生素 D 的男性股骨颈测量部位的 BMD 降低幅度显著较小(0.000 比 -0.010 g/cm,p=0.008)。在男性和女性中,在总髋部测量部位,干预组之间均未见明显差异。

结论

单独补充维生素 D 可能对糖尿病前期男性有益,但需要进一步的确认性研究。

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