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补充维生素D对非糖尿病成年人血糖和胰岛素稳态及新发糖尿病的影响:一项随机对照试验的荟萃分析

Effects of Vitamin D Supplementation on Glucose and Insulin Homeostasis and Incident Diabetes among Nondiabetic Adults: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Tang Huilin, Li Deming, Li Yufeng, Zhang Xi, Song Yiqing, Li Xinli

机构信息

Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.

Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.

出版信息

Int J Endocrinol. 2018 Dec 3;2018:7908764. doi: 10.1155/2018/7908764. eCollection 2018.

Abstract

AIMS

Emerging evidence has suggested a mechanistic link from vitamin D metabolism to glucose and insulin homeostasis. This study is aimed at specifically quantifying the direct effects of vitamin D supplementation on indexes of glucose and insulin homeostasis as well as incidence of type 2 diabetes (T2D) among nondiabetic adults.

METHODS

We systematically searched randomized controlled trials (RCTs) of vitamin D supplementation in nondiabetic adults in PubMed, EMBASE, and CENTRAL. Random-effects meta-analysis was conducted to pool the estimates.

RESULTS

Our meta-analysis included 47 RCTs involving 44,161 nondiabetic individuals with a median trial duration of 4 months and a median dose of 4000 IU/d. Vitamin D supplementation significantly reduced fasting glucose by 0.11 mmol/L, fasting insulin by 1.47 mIU/L, and HOMA-IR by 0.32 while increasing total 25 (OH) D levels by 40.14 nmol/L. We found no significant effects of vitamin D supplementation on insulin secretion or beta cell function indexes. Based on the data from six trials involving 39,633 participants and 2533 incident T2D cases, vitamin D supplementation was not associated with the risk of incident diabetes compared to placebo (pooled relative risk: 1.01, 95% confidence interval: 0.93 to 1.08).

CONCLUSIONS

Our meta-analysis found that vitamin D supplementation might improve glucose and insulin metabolism without affecting the risk of T2D among nondiabetic adults.

摘要

目的

新出现的证据表明维生素D代谢与葡萄糖及胰岛素稳态之间存在机制联系。本研究旨在具体量化补充维生素D对非糖尿病成年人的葡萄糖和胰岛素稳态指标以及2型糖尿病(T2D)发病率的直接影响。

方法

我们系统检索了PubMed、EMBASE和CENTRAL中关于非糖尿病成年人补充维生素D的随机对照试验(RCT)。进行随机效应荟萃分析以汇总估计值。

结果

我们的荟萃分析纳入了47项RCT,涉及44161名非糖尿病个体,试验持续时间中位数为4个月,剂量中位数为4000 IU/d。补充维生素D可使空腹血糖显著降低0.11 mmol/L,空腹胰岛素降低1.47 mIU/L,HOMA-IR降低0.32,同时使总25(OH)D水平升高40.14 nmol/L。我们发现补充维生素D对胰岛素分泌或β细胞功能指标无显著影响。基于六项试验的数据,涉及39633名参与者和2533例T2D发病病例,与安慰剂相比,补充维生素D与T2D发病风险无关(合并相对风险:1.01,95%置信区间:0.93至1.08)。

结论

我们的荟萃分析发现,补充维生素D可能改善葡萄糖和胰岛素代谢,而不影响非糖尿病成年人患T2D的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a9b/6304827/a049f9570ff2/IJE2018-7908764.001.jpg

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