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评估短期大剂量口服胆钙化醇对非裔美国人维生素 D 缺乏症患者选择的实验室和基因组反应的安慰剂对照随机试验的原理和设计。

Rationale and design of a placebo controlled randomized trial to assess short term, high-dose oral cholecalciferol on select laboratory and genomic responses in African Americans with hypovitaminosis D.

机构信息

University of California Los Angeles, Los Angeles, CA, USA.

Jackson State University, Jackson, MS, USA.

出版信息

Contemp Clin Trials. 2018 Sep;72:20-25. doi: 10.1016/j.cct.2018.07.006. Epub 2018 Jul 18.

Abstract

Cardiovascular Disease (CVD) and related disorders remain a leading cause of health disparities and premature death for African Americans. Hypovitaminosis D is disproportionately prevalent in African Americans and has been linked to CVD and CVD risk factors including hypertension, diabetes and obesity. Thus, hypovitaminosis D may represent a common pathway influencing CV risk factors in a select subgroup of persons. The purpose of this paper is to report the study design of a prospective eight week prospective double-blind randomized, placebo-controlled trial (n = 330 allocated 2:1 to intervention vs. control) to assess the effect of placebo vs. high-dose oral cholecalciferol (100,000 IU vitamin D3 at baseline and week 2) on 6-week change of select biologic cardiometabolic risk factors (including parathyroid hormone to assess biologic activity, pro-inflammatory/pro-thrombotic/fibrotic markers, insulin sensitivity and vitamin D metabolites) and their relationship to vitamin D administration and modification by vitamin D receptor polymorphisms in overweight, hypertensive African Americans with hypovitaminosis D. Findings from this trial will present insights into potential causal links between vitamin D repletion and mechanistic pathways of CV disease, including established and novel genomic markers.

摘要

心血管疾病(CVD)及相关疾病仍是造成非裔美国人健康差异和早逝的主要原因。非裔美国人普遍存在维生素 D 缺乏症,且其与 CVD 及 CVD 风险因素(包括高血压、糖尿病和肥胖)相关。因此,维生素 D 缺乏症可能代表影响特定亚组人群心血管风险因素的共同途径。本文旨在报告一项前瞻性八周、双盲、随机、安慰剂对照试验(n=330,按 2:1 比例分配至干预组和对照组)的研究设计,以评估安慰剂与高剂量口服胆钙化醇(100,000IU 维生素 D3 于基线和第 2 周)对超重、高血压、维生素 D 缺乏的非裔美国人选择的生物学心血管代谢风险因素(包括甲状旁腺激素以评估生物学活性、促炎/促血栓形成/纤维化标志物、胰岛素敏感性和维生素 D 代谢物)的 6 周变化的影响,及其与维生素 D 受体多态性对维生素 D 给药和修饰的关系。该试验的结果将提供关于维生素 D 补充与 CVD 机制途径之间潜在因果关系的见解,包括已建立和新的基因组标志物。

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