Brar Preneet Cheema, Contreras Maria, Fan Xiaozhou, Visavachaipan Nipapat
Department of Pediatrics, Division of Pediatric Endocrinology, New York University School of Medicine, New York, USA.
Texas Tech University Health Science Center, Department of Pediatrics, Amarillo, Texas, USA.
Arch Endocrinol Metab. 2018 Apr 5;62(2):193-200. doi: 10.20945/2359-3997000000024. Print 2018 Mar-Apr.
To study the effect of using a one time high dose "stoss therapy" of vitamin D2 (ergocalciferol: VD2) on indices of insulin sensitivity {whole body sensitivity index: WBISI} and secretion {insulinogenic index: IGI} measured during an oral glucose tolerance test (OGTT) in obese adolescents with VDD (25 OHD; serum metabolite of vit D: < 30 ng/dL).
In a randomized placebo controlled cross over design 20 obese adolescents with vitamin D deficiency (VDD) had baseline OGTT. Arm A received one time high dose 300,000 IU of ergocalciferol and Arm B received placebo. After 6 weeks the adolescents were reassigned to Arm A if they were in Arm B and vice versa. 25OHD, calcium, parathyroid hormone, comprehensive metabolic panel, urine calcium creatinine ratio were measured at each study visit. OGTTs to assess indices of sensitivity and secretion were done at baseline, 6 weeks and 12 weeks respectively.
Adolescents were obese and insulin resistant (mean ± SD: mean age = 15.1 ± 1.9 years; BMI: 32.7 ± 9.8; homeostatic model of insulin resistance: HOMA-IR: 4.2 ± 2.8). Stoss therapy with VD2 increased 25OHD from baseline (16.7 ± 2.9 to 19.5 ± 4.5; p = 0.0029) when compared to the placebo. WBISI (2.8 ± 1.9) showed a trend towards improvement in Rx group (p = 0.0577) after adjustment for covariates. IGI (3 ± 2.2) showed an improvement in both Rx and placebo groups.
Our study demonstrated that using a high dose of VD2 (300,000 IU) did not have any beneficial effect on insulin sensitivity (whole body sensitivity index {WBISI}) and secretory indices (insulinogenic index {IGI}) in obese adolescents. High dose "stoss therapy" of VD2 did not appear to have any beneficial effect on glucose homeostasis on obese adolescents.
研究一次性大剂量维生素D2（麦角钙化醇：VD2）“冲击疗法”对维生素D缺乏（25羟维生素D；维生素D的血清代谢产物：<30 ng/dL）的肥胖青少年口服葡萄糖耐量试验（OGTT）期间测量的胰岛素敏感性指标{全身敏感性指数：WBISI}和分泌指标{胰岛素生成指数：IGI}的影响。
在一项随机安慰剂对照交叉设计中，20名维生素D缺乏（VDD）的肥胖青少年进行了基线OGTT。A组接受一次性大剂量300,000 IU的麦角钙化醇，B组接受安慰剂。6周后，如果青少年在B组，则重新分配到A组，反之亦然。每次研究访视时测量25羟维生素D、钙、甲状旁腺激素、综合代谢指标、尿钙肌酐比值。分别在基线、6周和12周进行OGTT以评估敏感性和分泌指标。
青少年肥胖且胰岛素抵抗（平均值±标准差：平均年龄 = 15.1±1.9岁；BMI：32.7±9.8；胰岛素抵抗稳态模型：HOMA-IR：4.2±2.8）。与安慰剂相比，VD2冲击疗法使25羟维生素D从基线水平升高（16.7±2.9至19.5±4.5；p = 0.0029）。调整协变量后，治疗组的WBISI（2.8±1.9）显示出改善趋势（p = 0.0577）。IGI（3±2.2）在治疗组和安慰剂组中均有改善。
我们的研究表明，大剂量VD2（300,000 IU）对肥胖青少年的胰岛素敏感性（全身敏感性指数{WBISI}）和分泌指标（胰岛素生成指数{IGI}）没有任何有益影响。VD2的大剂量“冲击疗法”对肥胖青少年的葡萄糖稳态似乎没有任何有益影响。
