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补充维生素 D 可改善超重或肥胖 2 型糖尿病患者的 SIRT1、鸢尾素和葡萄糖指标:一项双盲随机安慰剂对照临床试验。

Vitamin D supplementation improves SIRT1, Irisin, and glucose indices in overweight or obese type 2 diabetic patients: a double-blind randomized placebo-controlled clinical trial.

机构信息

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Department of Nutrition, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran.

出版信息

BMC Fam Pract. 2020 Feb 7;21(1):26. doi: 10.1186/s12875-020-1096-3.

Abstract

BACKGROUND

Vitamin D (VD) may increase sirtuin 1 (SIRT1) and subsequently PPAR-γ coactivator 1α (PGC-1α) and irisin levels and these improvements may reduce insulin resistance (IR). The aim was to assess the effects of vitamin D supplementation on SIRT1, irisin, and IR in overweight/obese type 2 diabetes (T2D) patients.

METHODS

Ninety T2D males and females were recruited as a clinical trial study (mean of age and body mass index (BMI) of intervention and placebo groups were 50.05 ± 10.17 and 50.36 ± 10.2 yrs. and 31.37 ± 3.4 and 30.43 ± 3.2 kg/m, respectively). The inclusion criteria were T2D, VD deficient, BMI > 25 kg/m, and serum HbA1c < 8.5%. The exclusion criteria were using vitamin and mineral supplements, having any acute disease, recent modifying dose or type of drugs. The supplementation was 50,000 IU/week VD or placebo for 8 weeks. The demographic characteristics, anthropometrics, dietary intakes and physical activity status, sun exposure status, fasting blood sugar (FBS) and insulin, glycosylated hemoglobin (HbA1c), irisin, SIRT1, 25-hydroxy D3 (25(OH)VD), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were determined. The significant P-value was ≤0.05.

RESULTS

The increase of serum VD, SIRT1, and irisin in the intervention group was significant (p < 0.001). HbA1c was decreased significantly by 1%. The changes in the other glucose indices (FBS, insulin, and IR) were non-significant.

CONCLUSIONS

VD supplementation may improve T2D by decreasing HbA1c and increasing SIRT1 and irisin in VD deficient T2D patients. Further trials are suggested.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials, IRCT201604202365N11. Registered 21/08/2016, http://en.irct.ir/trial/2019.

摘要

背景

维生素 D(VD)可能会增加沉默信息调节因子 1(SIRT1),随后增加过氧化物酶体增殖物激活受体 γ 共激活因子 1α(PGC-1α)和鸢尾素的水平,这些改善可能会降低胰岛素抵抗(IR)。目的是评估维生素 D 补充对超重/肥胖 2 型糖尿病(T2D)患者 SIRT1、鸢尾素和 IR 的影响。

方法

90 名 T2D 男性和女性被招募为临床试验研究(干预组和安慰剂组的平均年龄和体重指数(BMI)分别为 50.05 ± 10.17 岁和 50.36 ± 10.2 岁,31.37 ± 3.4 千克/平方米和 30.43 ± 3.2 千克/平方米)。纳入标准为 T2D、VD 缺乏、BMI>25 千克/平方米和血清糖化血红蛋白(HbA1c)<8.5%。排除标准为使用维生素和矿物质补充剂、患有任何急性疾病、近期调整药物剂量或类型。补充剂为每周 50,000IU VD 或安慰剂,持续 8 周。测定人口统计学特征、人体测量学、饮食摄入和身体活动状况、阳光暴露状况、空腹血糖(FBS)和胰岛素、糖化血红蛋白(HbA1c)、鸢尾素、SIRT1、25-羟维生素 D3(25(OH)VD)、稳态模型评估的胰岛素抵抗(HOMA-IR)和定量胰岛素敏感性检查指数(QUICKI)。显著 P 值≤0.05。

结果

干预组血清 VD、SIRT1 和鸢尾素水平升高,差异有统计学意义(p<0.001)。HbA1c 降低 1%。其他血糖指标(FBS、胰岛素和 IR)的变化无统计学意义。

结论

维生素 D 补充可能通过降低 VD 缺乏的 T2D 患者的 HbA1c 以及增加 SIRT1 和鸢尾素来改善 T2D。建议进行进一步的试验。

试验注册

伊朗临床试验注册中心,IRCT201604202365N11。注册于 2016 年 8 月 21 日,http://en.irct.ir/trial/2019.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f62/7007689/ab66b05116ab/12875_2020_1096_Fig1_HTML.jpg

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