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长期维生素 D 补充与宫颈上皮内瘤变 2 或 3 级复发和代谢状态的影响:一项随机、双盲、安慰剂对照试验。

Long-Term Vitamin D Supplementation and the Effects on Recurrence and Metabolic Status of Cervical Intraepithelial Neoplasia Grade 2 or 3: A Randomized, Double-Blind, Placebo-Controlled Trial.

机构信息

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

Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

Ann Nutr Metab. 2018;72(2):151-160. doi: 10.1159/000487270. Epub 2018 Feb 21.

Abstract

OBJECTIVE

This study was conducted to evaluate the effects of vitamin D supplementation on the recurrence and metabolic status of patients with cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3).

METHODS

This randomized, double-blind, placebo-controlled trial was carried out among 58 women diagnosed with CIN2/3. Participants were randomly assigned into 2 groups to receive either 50,000 IU vitamin D3 (n = 29) or placebo (n = 29) every 2 weeks for 6 months.

RESULTS

The recurrence rate of CIN1/2/3 was 18.5 and 48.1% in the vitamin D and placebo groups respectively (p = 0.02). When we excluded CIN1, the recurrence rate of CIN2/3 became nonsignificant. Vitamin D supplementation significantly decreased fasting plasma glucose (-7.8 ± 9.2 vs. -1.1 ± 8.6 mg/dL, p = 0.006) and insulin levels (-3.2 ± 4.8 vs. -0.9 ± 3.4 µIU/mL, p = 0.03), and significantly increased quantitative insulin sensitivity check index (0.01 ± 0.02 vs. 0.002 ± 0.01, p = 0.02) compared with the placebo. Additionally, there was a significant decrease in high-sensitivity C-reactive protein (-815.3 ± 1,786.2 vs. 717.5 ± 1,827.3 ng/mL, p = 0.002) and a significant increase in total antioxidant capacity (113.4 ± 137.4 vs. -53.7 ± 186.7 mmol/L, p < 0.001) following the supplementation of vitamin D compared with the placebo.

CONCLUSIONS

Vitamin D3 supplementation for 6 months among women with CIN2/3 had beneficial effects on CIN1/2/3 recurrence and metabolic status; however, it did not affect CIN2/3 recurrence.

摘要

目的

本研究旨在评估维生素 D 补充对宫颈上皮内瘤变 2 级或 3 级(CIN2/3)患者复发和代谢状态的影响。

方法

这项随机、双盲、安慰剂对照试验纳入了 58 名被诊断为 CIN2/3 的女性。参与者被随机分为两组,分别接受 50,000IU 维生素 D3(n=29)或安慰剂(n=29),每 2 周 1 次,共 6 个月。

结果

维生素 D 组和安慰剂组的 CIN1/2/3 复发率分别为 18.5%和 48.1%(p=0.02)。当我们排除 CIN1 时,CIN2/3 的复发率变得无统计学意义。维生素 D 补充显著降低空腹血糖(-7.8±9.2 与-1.1±8.6mg/dL,p=0.006)和胰岛素水平(-3.2±4.8 与-0.9±3.4µIU/mL,p=0.03),并显著增加定量胰岛素敏感性检查指数(0.01±0.02 与 0.002±0.01,p=0.02)与安慰剂相比。此外,与安慰剂相比,维生素 D 补充后,高敏 C 反应蛋白显著下降(-815.3±1,786.2 与-717.5±1,827.3ng/mL,p=0.002),总抗氧化能力显著增加(113.4±137.4 与-53.7±186.7mmol/L,p<0.001)。

结论

在 CIN2/3 女性中补充维生素 D3 6 个月对 CIN1/2/3 的复发和代谢状态有有益的影响;然而,它对 CIN2/3 的复发没有影响。

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