Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jun 8;84(Pt A):50-55. doi: 10.1016/j.pnpbp.2018.02.007. Epub 2018 Feb 9.
BACKGROUND: This study was carried out to evaluate the effects of vitamin D and probiotic co-supplementation on mental health parameters and metabolic status in diabetic people with coronary heart disease (CHD). METHODS: This randomized, double-blind, placebo-controlled trial was carried out among 60 diabetic people with CHD, aged 45-85 years old. Subjects were randomly allocated into two groups to receive either 50,000 IU vitamin D every 2 weeks plus 8 × 10 CFU/g probiotic of Lactocare Zisttakhmir Co (n = 30) or placebo (n = 30) for 12 weeks. Fasting blood samples were obtained at baseline and after the 12-week intervention to determine metabolic profiles. RESULTS: After the 12-week intervention, compared with the placebo, vitamin D and probiotic co-supplementation resulted in significant improvements in beck depression inventory total score (-2.8 ± 3.8 vs. -0.9 ± 2.1, P = 0.01), beck anxiety inventory scores (-2.1 ± 2.3 vs. -0.8 ± 1.4, P = 0.009) and general health questionnaire scores (-3.9 ± 4.1 vs. -1.1 ± 3.4, P = 0.005). Compared with the placebo, vitamin D and probiotic co-supplementation resulted in significant reductions in serum insulin levels (-2.8 ± 3.8 vs. +0.2 ± 4.9 μIU/mL, P = 0.009), homeostasis model of assessment-estimated insulin resistance (-1.0 ± 1.6 vs. -0.1 ± 1.5, P = 0.02), and a significant increase in serum 25-OH-vitamin D (+11.8 ± 5.9 vs. +0.1 ± 1.4 ng/mL, P < 0.001), the quantitative insulin sensitivity check index (+0.03 ± 0.04 vs. -0.001 ± 0.01, P = 0.003) and serum HDL-cholesterol levels (+2.3 ± 3.5 vs. -0.5 ± 3.8 mg/dL, P = 0.004). In addition, changes in serum high sensitivity C-reactive protein (hs-CRP) (-950.0 ± 1811.2 vs. +260.5 ± 2298.2 ng/mL, P = 0.02), plasma nitric oxide (NO) (+1.7 ± 4.0 vs. -1.4 ± 6.7 μmol/L, P = 0.03) and plasma total antioxidant capacity (TAC) (+12.6 ± 41.6 vs. -116.9 ± 324.2 mmol/L, P = 0.03) in the supplemented group were significantly different from the changes in these indicators in the placebo group. CONCLUSIONS: Overall, vitamin D and probiotic co-supplementation after 12 weeks among diabetic people with CHD had beneficial effects on mental health parameters, serum hs-CRP, plasma NO, TAC, glycemic control and HDL-cholesterol levels. CLINICAL TRIAL REGISTRATION NUMBER: http://www.irct.ir: IRCT2017073033941N4.
背景：本研究旨在评估维生素 D 和益生菌联合补充对合并冠心病（CHD）的糖尿病患者心理健康参数和代谢状况的影响。
方法：这项随机、双盲、安慰剂对照试验在 60 名年龄在 45-85 岁之间合并 CHD 的糖尿病患者中进行。受试者被随机分为两组，分别接受 50,000IU 维生素 D 每 2 周一次加 Lactocare Zisttakhmir Co 的 8×10CFU/g 益生菌（n=30）或安慰剂（n=30），为期 12 周。在基线和 12 周干预后采集空腹血样，以确定代谢谱。
结果：与安慰剂组相比，经过 12 周的干预，维生素 D 和益生菌联合补充显著改善了贝克抑郁量表总分（-2.8±3.8 与-0.9±2.1，P=0.01）、贝克焦虑量表评分（-2.1±2.3 与-0.8±1.4，P=0.009）和一般健康问卷评分（-3.9±4.1 与-1.1±3.4，P=0.005）。与安慰剂组相比，维生素 D 和益生菌联合补充显著降低了血清胰岛素水平（-2.8±3.8 与+0.2±4.9 μIU/mL，P=0.009）、稳态模型评估的胰岛素抵抗（-1.0±1.6 与-0.1±1.5，P=0.02），以及血清 25-羟维生素 D 水平显著增加（+11.8±5.9 与+0.1±1.4 ng/mL，P<0.001）、定量胰岛素敏感性检查指数（+0.03±0.04 与-0.001±0.01，P=0.003）和血清高密度脂蛋白胆固醇水平（+2.3±3.5 与-0.5±3.8 mg/dL，P=0.004）。此外，补充组血清高敏 C 反应蛋白（hs-CRP）（-950.0±1811.2 与+260.5±2298.2 ng/mL，P=0.02）、血浆一氧化氮（NO）（+1.7±4.0 与-1.4±6.7 μmol/L，P=0.03）和血浆总抗氧化能力（TAC）（+12.6±41.6 与-116.9±324.2 mmol/L，P=0.03）的变化与安慰剂组这些指标的变化明显不同。
结论：总之，在合并 CHD 的糖尿病患者中，经过 12 周的维生素 D 和益生菌联合补充，对心理健康参数、血清 hs-CRP、血浆 NO、TAC、血糖控制和 HDL 胆固醇水平有有益影响。
临床试验注册号：http://www.irct.ir: IRCT2017073033941N4。
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