Mahmood Saba Fathima, Idiculla Jyothi, Joshi Rajnish, Joshi Shailesh, Kulkarni Shruthi
1 Medicine, St Johns National Academy of Medical Sciences, Bengaluru, India.
2 AIIMS, All India Institute of Medical Sciences, Bhopal, India.
Int J Vitam Nutr Res. 2016 Jun;86(3-4):121-126. doi: 10.1024/0300-9831/a000426. Epub 2018 Feb 22.
Inverse relationship between metabolic syndrome (MetS) and 25-hydroxyvitamin D (25(OH) D) levels is controversial. Hypovitaminosis-D has long been suspected as a risk factor for glucose intolerance.
A randomized double blind placebo controlled study to evaluate effects of vitamin D supplementation on insulin resistance in subjects with hypovitaminosis-D and MetS.
Subjects were randomized to receive either oral 25(OH) D3 supplement (60000 (IU) per week for 8 weeks followed by 60,000 IU monthly for 4 months) or a placebo for six months. The parameters measured were blood pressure, vitamin D, fasting blood sugar (FBS), insulin, homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), body mass index (BMI), and waist circumference (WC).
There were no significant changes in parameters of vitamin-D group compared to placebo group except serum vitamin-D was significantly increased in vitamin-D group (p < 0.0001). In vitamin-D group, mean WC at baseline was 95.9 ± 6.66, which significantly changed to 94.6 ± 7.47 (p = 0.001). Mean BMI at baseline was 29.1 ± 4.06 which significantly changed to 28.5 ± 4.16 (p = 0.001). The mean vitamin-D concentration at baseline was 15.4 ± 9.03 which significantly (p < .0001) increased to 26.1 ± 11.8. In placebo group mean insulin levels was 10.7 ± 4.81IU / L which increased significantly (p = 0.03) to 15.4 ± 14.0. Mean QUICKI at baseline was 0.34 ± 0.03 which decreased significantly (p = 0.02) to 0.32 ± 0.03.
In this study the relationship between vitamin D supplementation and MetS or IR was not established. Whether achieving vitamin D sufficiency in large population-based trials with a longer duration would produce more favorable results needs to be assessed.
代谢综合征（MetS）与25-羟基维生素D（25(OH)D）水平之间的负相关关系存在争议。长期以来，维生素D缺乏一直被怀疑是葡萄糖不耐受的一个风险因素。
一项随机双盲安慰剂对照研究，以评估补充维生素D对维生素D缺乏和代谢综合征患者胰岛素抵抗的影响。
受试者被随机分为两组，一组口服25(OH)D3补充剂（每周60000国际单位，共8周，之后每月60000国际单位，共4个月），另一组服用安慰剂，为期6个月。测量的参数包括血压、维生素D、空腹血糖（FBS）、胰岛素、稳态模型评估（HOMA）、定量胰岛素敏感性检查指数（QUICKI）、体重指数（BMI）和腰围（WC）。
与安慰剂组相比，维生素D组除血清维生素D显著升高（p < 0.0001）外，其他参数无显著变化。在维生素D组，基线时平均腰围为95.9±6.66，显著变为94.6±7.47（p = 0.001）。基线时平均BMI为29.1±4.06，显著变为28.5±4.16（p = 0.001）。基线时平均维生素D浓度为15.4±9.03，显著（p <.0001）升至26.1±11.8。在安慰剂组，平均胰岛素水平为10.7±4.81IU/L，显著升高（p = 0.03）至15.4±14.0。基线时平均QUICKI为0.34±0.03，显著降低（p = 0.02）至0.32±0.03。
在本研究中，补充维生素D与代谢综合征或胰岛素抵抗之间的关系未得到证实。在大规模、持续时间更长的基于人群的试验中实现维生素D充足是否会产生更有利的结果，有待评估。
