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维生素 D 补充对 2 型糖尿病和慢性肾脏病患者的代谢参数无影响,但对脂质有影响。

No effect of vitamin D supplementation on metabolic parameters but on lipids in patients with type 2 diabetes and chronic kidney disease.

机构信息

Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.

Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Int J Vitam Nutr Res. 2021 Sep;91(5-6):649-658. doi: 10.1024/0300-9831/a000642. Epub 2020 Mar 9.

Abstract

Trials on the effects of cholecalciferol supplementation in type 2 diabetes with chronic kidney disease patients were underexplored. Therefore, the aim of this study was to investigate the effects of two different doses of vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] concentrations and metabolic parameters in vitamin D-deficient Korean diabetes patients with chronic kidney disease. 92 patients completed this study: the placebo group (A, n = 33), the oral cholecalciferol 1,000 IU/day group (B, n = 34), or the single 200,000 IU injection group (C, n = 25, equivalent to 2,000 IU/day). 52% of the patients had less than 60 mL/min/1.73m of glomerular filtration rates. Laboratory test and pulse wave velocity were performed before and after supplementation. After 12 weeks, serum 25(OH)D concentrations of the patients who received vitamin D supplementation were significantly increased (A, -2.4 ± 1.2 ng/mL vs. B, 10.7 ± 1.2 ng/mL vs. C, 14.6 ± 1.7 ng/mL;  < 0.001). In addition, the lipid profiles in the vitamin D injection group (C) showed a significant decrease in triglyceride and a rise in HDL cholesterol. However, the other parameters showed no differences. Our data indicated that two different doses and routes of vitamin D administration significantly and safely increased serum 25(OH)D concentrations in vitamin D-deficient diabetes patients with comorbid chronic kidney disease. In the group that received the higher vitamin D dose, the lipid profiles showed significant improvement, but there were no beneficial effects on other metabolic parameters.

摘要

关于补充胆钙化醇对 2 型糖尿病合并慢性肾脏病患者的影响的临床试验研究甚少。因此,本研究旨在探讨两种不同剂量的维生素 D 补充剂对维生素 D 缺乏的韩国 2 型糖尿病合并慢性肾脏病患者血清 25-羟维生素 D [25(OH)D]浓度和代谢参数的影响。92 例患者完成了这项研究:安慰剂组(A,n=33)、口服胆钙化醇 1000IU/天组(B,n=34)或单次 200000IU 注射组(C,n=25,相当于 2000IU/天)。52%的患者肾小球滤过率<60ml/min/1.73m。补充前后进行实验室检查和脉搏波速度检查。12 周后,接受维生素 D 补充的患者血清 25(OH)D 浓度显著升高(A:-2.4±1.2ng/ml;B:10.7±1.2ng/ml;C:14.6±1.7ng/ml;P<0.001)。此外,维生素 D 注射组(C)的血脂谱显示甘油三酯显著降低,HDL 胆固醇升高。然而,其他参数没有差异。我们的数据表明,两种不同剂量和途径的维生素 D 给药可显著且安全地增加合并慢性肾脏病的维生素 D 缺乏 2 型糖尿病患者的血清 25(OH)D 浓度。在接受较高维生素 D 剂量的组中,血脂谱显示出显著改善,但对其他代谢参数没有有益影响。

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