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维生素D改善2型糖尿病患者的收缩压而非舒张压:随机对照试验的荟萃分析结果

Vitamin D ameliorates systolic but not diastolic blood pressure in patients with type 2 diabetes: Results from a meta-analysis of randomized controlled trials.

作者信息

Jafari Tina, Fallah Aziz A, Rostampour Noushin, Mahmoodnia Leila

机构信息

1 Department of Biochemistry and Nutrition, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

2 Medical Plants Research Center, Shahrekord University of Medical Sciences, Sharhekord, Iran.

出版信息

Int J Vitam Nutr Res. 2018 Feb;88(1-2):90-99. doi: 10.1024/0300-9831/a000291. Epub 2019 Apr 30.

Abstract

Inconsistent findings have been reported regarding the effects of vitamin D on blood pressure in patients with type 2 diabetes (T2D). This study aimed to evaluate the subject through a meta-analysis. A computerized literature search on five databases was performed and randomized controlled trials (RCTs) published until March 2016 were identified. The eligibility criteria for articles to be selected were parallel-group RCTs in which consumption of a kind of vitamin D was compared with placebo in patients with T2D. Un-standardized mean difference and its corresponding 95 % confidence interval (CI) was calculated from the effect sizes by using random effects model. Studies comparing intervention group (received vitamin D) with control group (received placebo) were enrolled in meta-analysis. Meta-analysis on 26 studies with 1789 type 2 diabetic subjects showed that vitamin D significantly reduced systolic blood pressure (SBP; -0.97 mmHg, 95 % CI: -1.94, -0.001, P = 0.050), but not diastolic blood pressure (DBP; -0.10 mmHg, 95 % CI: -0.22, 0.02, P = 0.087). Subgroup analyses showed that administration of vitamin D in patients with baseline serum 25-hydroxy vitamin D < 50 nmol/l and baseline SBP < 140 mmHg significantly reduced SBP. Moreover, the patients who received vitamin D without Ca co-supplementation showed significant reduction in SBP. Vitamin D doses (≤ 2000 or > 2000 IU/day) and method of vitamin D application (Supplementation or food fortification) did not affect the blood pressure. This study demonstrated that vitamin D improved SBP in type 2 diabetic patients. Therefore, this vitamin can be considered as an adjuvant therapy in these patients.

摘要

关于维生素D对2型糖尿病(T2D)患者血压的影响,已有不一致的研究结果报道。本研究旨在通过荟萃分析评估这一问题。我们在五个数据库中进行了计算机化文献检索,确定了截至2016年3月发表的随机对照试验(RCT)。入选文章的纳入标准为平行组RCT,其中将一种维生素D的摄入量与T2D患者的安慰剂进行比较。采用随机效应模型,从效应量计算未标准化的平均差及其相应的95%置信区间(CI)。比较干预组(接受维生素D)和对照组(接受安慰剂)的研究纳入荟萃分析。对26项研究共1789名2型糖尿病受试者的荟萃分析表明,维生素D显著降低收缩压(SBP;-0.97 mmHg,95% CI:-1.94,-0.001,P = 0.050),但对舒张压(DBP;-0.10 mmHg,95% CI:-0.22,0.02,P = 0.087)无显著影响。亚组分析显示,基线血清25-羟基维生素D < 50 nmol/l且基线SBP < 140 mmHg的患者服用维生素D可显著降低SBP。此外,未同时补充钙而接受维生素D的患者SBP显著降低。维生素D剂量(≤ 2000或> 2000 IU/天)及维生素D应用方法(补充或食物强化)对血压无影响。本研究表明,维生素D可改善2型糖尿病患者的SBP。因此,这种维生素可被视为这些患者的辅助治疗方法。

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