Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred Heart, Rome, Italy.
Internal Medicine and Transplant Unit, San Raffaele Hospital, Milan, Italy.
Obesity (Silver Spring). 2018 Apr;26(4):651-657. doi: 10.1002/oby.22132. Epub 2018 Mar 4.
The aim was to investigate whether vitamin D supplementation, combined with a hypocaloric diet, could have an independent effect on insulin sensitivity in subjects with both overweight and hypovitaminosis D. Changes from baseline in anthropometric parameters, body composition, glucose tolerance, and insulin secretion were considered as secondary outcomes.
Eighteen volunteers who were nondiabetic and vitamin D deficient and had BMI > 25 kg/m were randomized (1:1) in a double-blind manner to a hypocaloric diet + either oral cholecalciferol at 25,000 IU/wk or placebo for 3 months. Hyperinsulinemic-euglycemic clamp to measure insulin sensitivity was performed at baseline and after intervention.
Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Serum 25-hydroxyvitamin D levels in the vitamin D group increased considerably (from 36.7 ± 13.2 nmol/L to 74.8 ± 18.7 nmol/L; P < 0.001). Insulin sensitivity in the vitamin D group improved (from 4.6 ± 2.0 to 6.9 ± 3.3 mg·kg ·min ; P < 0.001), whereas no changes were observed in the placebo group (from 4.9 ± 1.1 to 5.1 ± 0.3 mg·kg ·min ; P = 0.84).
Cholecalciferol supplementation, combined with a weight loss program, significantly improves insulin sensitivity in healthy subjects with obesity and might represent a personalized approach for insulin-resistant subjects with obesity.
研究维生素 D 补充剂与低热量饮食相结合是否对超重伴维生素 D 缺乏的受试者的胰岛素敏感性有独立作用。将基线时的人体测量参数、身体成分、葡萄糖耐量和胰岛素分泌的变化作为次要结局来考虑。
18 名非糖尿病且维生素 D 缺乏且 BMI>25kg/m²的志愿者被随机（1:1）分为双盲组，分别接受低热量饮食+每周 25,000IU 口服胆钙化醇或安慰剂治疗 3 个月。在基线和干预后进行高胰岛素-正葡萄糖钳夹以测量胰岛素敏感性。
两组体重均明显下降（维生素 D 组下降 7.5%，安慰剂组下降 10%；均 P<0.05），但两组间无差异。维生素 D 组血清 25-羟维生素 D 水平显著升高（从 36.7±13.2nmol/L 增加至 74.8±18.7nmol/L；P<0.001）。维生素 D 组胰岛素敏感性改善（从 4.6±2.0 增加至 6.9±3.3mg·kg·min；P<0.001），而安慰剂组无变化（从 4.9±1.1 增加至 5.1±0.3mg·kg·min；P=0.84）。
胆钙化醇补充剂联合减肥计划可显著改善肥胖健康受试者的胰岛素敏感性，可能代表肥胖胰岛素抵抗患者的个体化治疗方法。
