Yu Lu, Zhai Yu, Shen Shanmei
Department of endocrinology, Changzhou Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou.
Department of endocrinology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing.
Medicine (Baltimore). 2020 Feb;99(8):e19034. doi: 10.1097/MD.0000000000019034.
Previous studies showed conflicting results for associations between vitamin D and prediabetes. The study aimed to make a systematic review and meta-analysis for the association between vitamin D and prediabetes.
We searched for articles identifying associations between vitamin D and prediabetes published in English until July 2019 in following databases (PubMed, Web of Science, EMBASE, Medline, Google Scholar, and Cochrane databases). Finally, we conducted these analyses (heterogeneities examination, meta-regression analyses, sensitivity analysis, and publication bias examination) using STATA 12.0 software (Stata Corporation, College Station, TX, USA). Q test and I were applied to examine heterogeneities between studies.
Twelve studies were finally included in the present study. The study included 4 studies to explore the association between serum levels of 25-hydroxy (OH) vitamin D and risks of prediabetes (including 3094 participants). Additionally, the present study included 8 studies (including 865 individuals with prediabetes treated with vitamin D supplementation and 715 patients treated with placebo) to assess differences in therapeutic effects between individuals with prediabetes treated with vitamin D supplementation and those treated with placebo. The present study showed no significant associations between low serum levels of 25(OH) vitamin D and high risk of prediabetes. Additionally, the study showed no significant differences in changes of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) between individuals with prediabetes treated with vitamin D and those patients given placebo, whereas meta-analysis showed significantly greater changes in 2-hour oral glucose tolerance test (2HPG) in individuals with prediabetes treated with vitamin D, compared with individuals with prediabetes treated with placebo.
The study supported that low serum levels of 25(OH) vitamin D increased the risk of prediabetes. In addition, vitamin D supplementation improves impaired glucose tolerance in prediabetes. However, more large-scale clinical trials are essential to explore the association between vitamin D and prediabetes.
既往研究显示维生素D与糖尿病前期之间的关联结果相互矛盾。本研究旨在对维生素D与糖尿病前期之间的关联进行系统评价和荟萃分析。
我们检索了截至2019年7月在以下数据库(PubMed、科学网、EMBASE、医学期刊数据库、谷歌学术和考克兰数据库)中发表的确定维生素D与糖尿病前期之间关联的英文文章。最后,我们使用STATA 12.0软件(美国德克萨斯州大学站市的Stata公司)进行了这些分析(异质性检验、荟萃回归分析、敏感性分析和发表偏倚检验)。应用Q检验和I检验来检查研究之间的异质性。
本研究最终纳入了12项研究。该研究包括4项探讨血清25-羟基(OH)维生素D水平与糖尿病前期风险之间关联的研究(包括3094名参与者)。此外,本研究包括8项研究(包括865名接受维生素D补充治疗的糖尿病前期个体和715名接受安慰剂治疗的患者),以评估接受维生素D补充治疗的糖尿病前期个体与接受安慰剂治疗的个体之间治疗效果的差异。本研究显示血清25(OH)维生素D水平低与糖尿病前期高风险之间无显著关联。此外,该研究显示,接受维生素D治疗的糖尿病前期个体与接受安慰剂治疗的患者在糖化血红蛋白(HbA1c)、空腹血糖(FPG)和胰岛素抵抗稳态模型评估(HOMA-IR)变化方面无显著差异,而荟萃分析显示,与接受安慰剂治疗的糖尿病前期个体相比,接受维生素D治疗的糖尿病前期个体在2小时口服葡萄糖耐量试验(2HPG)中的变化显著更大。
该研究支持血清25(OH)维生素D水平低会增加糖尿病前期风险。此外,补充维生素D可改善糖尿病前期受损的糖耐量。然而,需要更多大规模临床试验来探索维生素D与糖尿病前期之间的关联。