Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
J Steroid Biochem Mol Biol. 2019 Jul;191:105378. doi: 10.1016/j.jsbmb.2019.105378. Epub 2019 May 8.
There is little evidence on the efficacy of various vitamin D supplementation strategies in reversing metabolic syndrome (MetS) in adolescents. The present study aims to fill this gap. A total of 535 (243/292) out of 650 apparently healthy Saudi adolescents were randomly selected from the Vitamin D School Project database which has baseline and post-intervention information of more than 1000 Saudi adolescents 12-18 years old attending 34 schools in Riyadh, Saudi Arabia from Nov 2014-May 2015. Allocation of intervention was done in 3 groups using cluster randomization: vitamin D tablet, 1000IU/day (N = 180; 69 boys, 111 girls); vitamin D fortified milk consumption, 200 ml/day, 40IU/100 ml (N = 189; 93 boys, 96 girls) and control (educational awareness) (N = 166; 81 boys, 85 girls). All groups were given educational awareness on how to increase vitamin D levels. All groups were matched for BMI and analysis adjusted for age. Post-intervention and using intent-to-treat approach, within-group analysis revealed a statistically significant increase in 25(OH)D levels in all groups, and a clinically significant increase in favor of the tablet group (between-group) [10.7 nmol/l (34.7%) versus 6.3 nmol/l (19.8%) in milk and 2.1 nmol/l (7.0%) in control; p < 0.001], adjusted for age and BMI-matched. Between group analysis also revealed a clinically significant decrease in triglycerides (p = 0.05), glucose (p < 0.001) and systolic blood pressure (p = 0.005) as well as a clinically significant increase in HDL-cholesterol (p = 0.004) over time, all in favor of the tablet group. Within-group comparison showed a significant decrease in the incidence of MetS in the tablet group (9.4% versus 4.4%; p < 0.05) only. In conclusion, oral vitamin D supplementation is superior to vitamin D fortified milk in improving vitamin D status. Reduction in the incidence of MetS in the Arab adolescent population secondary to vitamin D correction may be dose-dependent.
关于各种维生素 D 补充策略在逆转青少年代谢综合征 (MetS) 方面的疗效，目前的研究旨在填补这一空白。本研究从 Vitamin D School Project 数据库中随机抽取了 535 名（243/292）看似健康的沙特青少年，这些青少年都在沙特阿拉伯利雅得的 34 所学校接受过 12-18 岁的 1000 多名沙特青少年的基线和干预后信息。使用整群随机分组将干预分配到 3 个组中：维生素 D 片，每天 1000IU（N=180；69 名男孩，111 名女孩）；每天饮用 200 毫升强化维生素 D 的牛奶，40IU/100 毫升（N=189；93 名男孩，96 名女孩）和对照组（教育意识）（N=166；81 名男孩，85 名女孩）。所有组都接受了如何提高维生素 D 水平的教育意识。所有组的 BMI 相匹配，并且分析根据年龄进行了调整。在干预后，采用意向治疗方法，对各组进行分析发现，所有组的 25(OH)D 水平均有统计学显著增加，且片剂组的增加具有临床意义（组间）[10.7 nmol/l（34.7%）比牛奶组的 6.3 nmol/l（19.8%）和对照组的 2.1 nmol/l（7.0%）；p<0.001]，经年龄和 BMI 匹配调整后。组间分析还显示，甘油三酯（p=0.05）、葡萄糖（p<0.001）和收缩压（p=0.005）随时间的临床显著降低，以及高密度脂蛋白胆固醇（HDL-cholesterol）的临床显著升高（p=0.004），所有这些都有利于片剂组。组内比较显示，仅片剂组的 MetS 发生率有显著降低（9.4%比 4.4%；p<0.05）。总之，口服维生素 D 补充剂在改善维生素 D 状态方面优于强化维生素 D 的牛奶。由于维生素 D 的纠正，阿拉伯青少年人群 MetS 的发生率降低可能与剂量有关。
