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补充维生素D对非酒精性脂肪性肝病患者各项参数的影响。

Effect of vitamin D supplementation on various parameters in non-alcoholic fatty liver disease patients.

作者信息

Hussain Mazhar, Iqbal Javed, Malik Saeed Akhtar, Waheed Akbar, Shabnum Shazia, Akhtar Lubna, Saeed Hira

机构信息

Department of Pharmacology, Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan.

Department of Medicine, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan.

出版信息

Pak J Pharm Sci. 2019 May;32(3 Special):1343-1348.

Abstract

There are still no FDA approved drugs for NAFLD so far. Vitamin D may be a good therapeutic option for NAFLD patients due to its insulin sensitizing and anti-inflammatory properties. The purpose is to investigate the effect of oral vitamin D supplementation on various parameters in NAFLD patients. In this double blind randomized placebo controlled trial, 109 patients of NAFLD diagnosed by abdominal ultrasound and liver enzymes were divided into two groups for treatment with oral capsule of vitamin D3 50,000 IU and capsule placebo weekly for a period of 12 weeks. Anthropometric, chemical, metabolic and inflammatory parameters were assessed pre and post treatment by using SPSS 16. After 12 weeks oral treatment with vitamin D , its level increased significantly in vitamin D group from 12.5±4.2 to 24.5±3.8 ng/ml p =0.003 vs placebo group. This rise was further accompanied by decrease in HOMA-IR (4.56±1.6 to 3.26± 1.8 p=0.003) liver enzymes (i.e. ALT: 72.±17.6 to 54.5±14.5 IU/L p=0.04; AST: 68±14.5 to 46.± 10.5 p =0.002) serum CRP 3.25±0.68 to 2.28±0.44 mg/L p =0.06 and increase in serum adiponectin 8.56 ±1.12 to 10.44±2.35 mg/L p =0.03 as compared to placebo group. However non significant changes were observed in both groups in terms of body weight, BMI, and serum lipid profiles. Vitamin D supplementation not only improved its own status but also caused a significant amelioration in metabolic, chemical and inflammatory parameters in NAFLD patients. So it should be consider as an adjunctive therapy in NAFLD patients.

摘要

到目前为止,美国食品药品监督管理局(FDA)仍未批准用于治疗非酒精性脂肪性肝病(NAFLD)的药物。由于维生素D具有胰岛素增敏和抗炎特性,它可能是NAFLD患者的一种良好治疗选择。目的是研究口服补充维生素D对NAFLD患者各项参数的影响。在这项双盲随机安慰剂对照试验中,109例经腹部超声和肝酶诊断为NAFLD的患者被分为两组,分别接受每周一次口服50,000国际单位维生素D3胶囊和胶囊安慰剂治疗,为期12周。使用SPSS 16在治疗前后评估人体测量学、化学、代谢和炎症参数。维生素D组口服治疗12周后,其水平从12.5±4.2显著升高至24.5±3.8 ng/ml,与安慰剂组相比,p = 0.003。这种升高还伴随着稳态模型评估的胰岛素抵抗(HOMA-IR)降低(从4.56±1.6降至3.26±1.8,p = 0.003)、肝酶降低(即谷丙转氨酶:从72.±17.6降至54.5±14.5 IU/L,p = 0.04;谷草转氨酶:从68±14.5降至46.±10.5,p = 0.002)、血清C反应蛋白(CRP)从3.25±0.68降至2.28±0.44 mg/L,p = 0.06,以及血清脂联素升高(从8.56±1.12升至10.44±2.35 mg/L,p = 0.03),与安慰剂组相比。然而,两组在体重、体重指数(BMI)和血脂谱方面均未观察到显著变化。补充维生素D不仅改善了其自身状态,还使NAFLD患者的代谢、化学和炎症参数得到了显著改善。因此,它应被视为NAFLD患者的辅助治疗方法。

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