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维生素 D 及其类似物在糖尿病肾病中的作用:一项荟萃分析。

Role of Vitamin D and Its Analogues in Diabetic Nephropathy: A Meta-analysis.

机构信息

Department of Medicine, St. Vincent's Medical Center, Bridgeport, Connecticut; The Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut.

The Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut; Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut.

出版信息

Am J Med Sci. 2019 Mar;357(3):223-229. doi: 10.1016/j.amjms.2018.12.005. Epub 2018 Dec 13.

Abstract

BACKGROUND

Diabetic nephropathy remains one of the most common causes of chronic kidney disease in the United States and is associated with significant morbidity and mortality. Recently, there have been emerging data highlighting the role of vitamin D and its analogue in chronic kidney disease especially diabetic nephropathy independent of its effect on bone metabolism.

METHODS

This study aimed to evaluate effect of supplementing vitamin D and its analogues on halting or slowing progression of diabetic nephropathy. Electronic databases (PubMed, Scopus, Google scholar) were searched and randomized controlled trials (RCTs) that investigated the use of vitamin D and its analogs for diabetic nephropathy were studied. This meta-analysis of RCTs performed in accordance with Preferred Reporting Items for Systematic review and Meta-analysis statement.

RESULTS

This meta-analysis included 9 RCTs and suggested a favorable trend with respect to an effect of vitamin D and its analogues on albuminuria though this did not reach statistical significance (MD, -0.17; 95% CI, -0.34-0.01; P = 0.06]. Serum calcium was unaffected suggesting safe use of these agents.

CONCLUSIONS

Use of vitamin D and its analogues may have potential as an adjuvant therapy for reducing albuminuria and slowing progression of diabetic nephropathy but further studies are needed.

摘要

背景

糖尿病肾病仍然是美国最常见的慢性肾脏病病因之一,与显著的发病率和死亡率相关。最近,有越来越多的数据强调了维生素 D 及其类似物在慢性肾脏病中的作用,特别是在糖尿病肾病中,而与骨代谢无关。

方法

本研究旨在评估补充维生素 D 及其类似物对阻止或减缓糖尿病肾病进展的作用。电子数据库(PubMed、Scopus、Google Scholar)进行了检索,并研究了维生素 D 及其类似物用于糖尿病肾病的随机对照试验(RCT)。本荟萃分析是按照系统评价和荟萃分析报告的首选报告项目进行的。

结果

本荟萃分析纳入了 9 项 RCT,表明维生素 D 及其类似物对蛋白尿的作用有良好的趋势,但未达到统计学意义(MD,-0.17;95%CI,-0.34-0.01;P=0.06)。血清钙不受影响,表明这些药物的使用是安全的。

结论

维生素 D 及其类似物的使用可能具有作为辅助治疗减少蛋白尿和减缓糖尿病肾病进展的潜力,但需要进一步的研究。

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