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镁和维生素 E 联合补充对糖尿病足溃疡患者伤口愈合和代谢状态的影响:一项随机、双盲、安慰剂对照试验。

The effects of magnesium and vitamin E co-supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial.

机构信息

Department of Infectious Disease, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Infections Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

Wound Repair Regen. 2019 May;27(3):277-284. doi: 10.1111/wrr.12701. Epub 2019 Feb 11.

Abstract

This study was carried out to determine the effects of magnesium and vitamin E co-supplementation on wound healing and metabolic status in patients with diabetic foot ulcer (DFU). The current randomized, double-blind, placebo-controlled trial was conducted among 57 patients with grade 3 DFU. Participants were randomly divided into two groups to take either 250 mg magnesium oxide plus 400 IU vitamin E (n = 29) or placebo per day (n = 28) for 12 weeks. Compared with the placebo, taking magnesium plus vitamin E supplements reduced ulcer length (β [difference in the mean of outcomes measures between treatment groups] -0.56 cm; 95% CI, -0.92, -0.20; p = 0.003), width (β -0.35 cm; 95% CI, -0.64, -0.05; p = 0.02) and depth (β -0.18 cm; 95% CI, -0.33, -0.02; p = 0.02). In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β -13.41 mg/dL; 95% CI, -20.96, -5.86; p = 0.001), insulin (β -1.45 μIU/ml; 95% CI, -2.37, -0.52; p = 0.003), insulin resistance (β -0.60; 95% CI, -0.99, -0.20; p = 0.003) and HbA1c (β -0.32%; 95% CI, -0.48, -0.16; p < 0.003), and a significant elevation in insulin sensitivity (β 0.007; 95% CI, 0.003, 0.01; p < 0.001) compared with the placebo. Additionally, compared with the placebo, taking magnesium plus vitamin E supplements decreased triglycerides (β -10.08 mg/dL; 95% CI, -19.70, -0.46; p = 0.04), LDL-cholesterol (β -5.88 mg/dL; 95% CI, -11.42, -0.34; p = 0.03), high sensitivity C-reactive protein (hs-CRP) (β -3.42 mg/L; 95% CI, -4.44, -2.41; p < 0.001) and malondialdehyde (MDA) (β -0.30 μmol/L; 95% CI, -0.45, -0.15; p < 0.001), and increased HDL-cholesterol (β 2.62 mg/dL; 95% CI, 0.60, 4.63; p = 0.01) and total antioxidant capacity (TAC) levels (β 53.61 mmol/L; 95% CI, 4.65, 102.57; p = 0.03). Overall, magnesium and vitamin E co-supplementation for 12 weeks to patients with DFU had beneficial effects on ulcer size, glycemic control, triglycerides, LDL- and HDL-cholesterol, hs-CRP, TAC, and MDA levels.

摘要

本研究旨在确定镁和维生素 E 联合补充对糖尿病足溃疡(DFU)患者伤口愈合和代谢状态的影响。目前的随机、双盲、安慰剂对照试验在 57 名 3 级 DFU 患者中进行。参与者被随机分为两组,分别每天服用 250mg 氧化镁加 400IU 维生素 E(n=29)或安慰剂(n=28),共 12 周。与安慰剂相比,服用镁加维生素 E 补充剂可减少溃疡长度(β差异治疗组之间的结局指标平均值[0.56cm;95%CI,-0.92,-0.20;p=0.003])、宽度(β -0.35cm;95%CI,-0.64,-0.05;p=0.02)和深度(β -0.18cm;95%CI,-0.33,-0.02;p=0.02)。此外,联合补充可显著降低空腹血糖(β -13.41mg/dL;95%CI,-20.96,-5.86;p=0.001)、胰岛素(β -1.45μIU/ml;95%CI,-2.37,-0.52;p=0.003)、胰岛素抵抗(β -0.60;95%CI,-0.99,-0.20;p=0.003)和糖化血红蛋白(HbA1c)(β -0.32%;95%CI,-0.48,-0.16;p<0.003),并显著提高胰岛素敏感性(β 0.007;95%CI,0.003,0.01;p<0.001)与安慰剂相比。此外,与安慰剂相比,服用镁加维生素 E 补充剂可降低甘油三酯(β -10.08mg/dL;95%CI,-19.70,-0.46;p=0.04)、LDL-胆固醇(β -5.88mg/dL;95%CI,-11.42,-0.34;p=0.03)、高敏 C 反应蛋白(hs-CRP)(β -3.42mg/L;95%CI,-4.44,-2.41;p<0.001)和丙二醛(MDA)(β -0.30μmol/L;95%CI,-0.45,-0.15;p<0.001),并提高高密度脂蛋白胆固醇(β 2.62mg/dL;95%CI,0.60,4.63;p=0.01)和总抗氧化能力(TAC)水平(β 53.61mmol/L;95%CI,4.65,102.57;p=0.03)。总的来说,DFU 患者补充镁和维生素 E 联合治疗 12 周对溃疡大小、血糖控制、甘油三酯、LDL 和 HDL-胆固醇、hs-CRP、TAC 和 MDA 水平均有有益影响。

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