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遗传因素对 VIDARIS 随机对照试验中维生素 D 补充反应的影响。

Effect of genetic factors on the response to vitamin D supplementation in the VIDARIS randomized controlled trial.

机构信息

Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.

Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.

出版信息

Nutrition. 2020 Jul-Aug;75-76:110761. doi: 10.1016/j.nut.2020.110761. Epub 2020 Feb 12.

Abstract

OBJECTIVES

Supplementation provides the best means of improving vitamin D status; however, individual responses vary partly owing to genetics. The aim of this study was to determine whether 28 single nucleotide polymorphisms (SNPs) in six key vitamin D pathway genes (GC, DHCR7, CYP2 R1, CYP24 A1, CYP27 B1, VDR) were associated with differences in response to supplementation.

METHODS

Participants (N = 313; n = 160 vitamin D, n = 153 placebo) were part of VIDARIS (Vitamin D and Acute Respiratory Infections Study), a double-blind, randomized controlled trial involving oral monthly supplementation of either vitamin D (200 000 IU each for the first 2 mo, thereafter 100 000 IU monthly) or placebo for 18 mo. Circulating 25-hydroxyvitamin D (25[OH]D) concentrations at baseline and 2, 6, 12, and 18 mo, and vitamin D binding protein (Gc-globulin) and calculated free 25(OH)D concentrations at baseline and 2 mo were obtained. Multiple regression was used to model associations between genetic variants and 25(OH)D, Gc-globulin, and free 25(OH)D concentrations.

RESULTS

SNPs within GC, CYP2 R1, and CYP27 B1 were associated with 25(OH)D concentrations following supplementation. However, only two GC gene SNPs (rs2282679, rs1155563) were significant after adjustment for multiple testing. This effect disappeared after more than 2 mo of supplementation. None of the SNPs were significantly associated with Gc-globulin concentrations; however, there was a significant interaction with one SNP in DHCR7 (rs12785878), which was associated with reduced free 25(OH)D concentrations in the supplemented arm.

CONCLUSION

Only variants of GC were associated with 25(OH)D concentrations after supplementation. This effect was modest and disappeared after >2 mo of supplementation, suggesting it may be time/dose-dependent and saturable.

摘要

目的

补充是改善维生素 D 状态的最佳手段;然而,个体反应部分归因于遗传。本研究旨在确定六个关键维生素 D 途径基因(GC、DHCR7、CYP2R1、CYP24A1、CYP27B1、VDR)中的 28 个单核苷酸多态性(SNP)是否与补充剂的反应差异相关。

方法

参与者(N=313;n=160 例维生素 D,n=153 例安慰剂)是 VIDARIS(维生素 D 和急性呼吸道感染研究)的一部分,这是一项双盲、随机对照试验,涉及口服每月补充维生素 D(前 2 个月每次 20 万 IU,此后每月 10 万 IU)或安慰剂 18 个月。在基线、2、6、12 和 18 个月时获得循环 25-羟维生素 D(25[OH]D)浓度,以及基线和 2 个月时的维生素 D 结合蛋白(Gc-球蛋白)和计算的游离 25(OH)D 浓度。多元回归用于建立遗传变异与 25(OH)D、Gc-球蛋白和游离 25(OH)D 浓度之间的关系模型。

结果

GC、CYP2R1 和 CYP27 B1 内的 SNP 与补充后 25(OH)D 浓度相关。然而,只有两个 GC 基因 SNP(rs2282679、rs1155563)在经过多次检验调整后具有统计学意义。这种影响在补充超过 2 个月后消失。没有 SNP 与 Gc-球蛋白浓度显著相关;然而,DHCR7(rs12785878)中的一个 SNP 存在显著的相互作用,与补充组中游离 25(OH)D 浓度降低有关。

结论

只有 GC 的变体与补充后的 25(OH)D 浓度相关。这种影响是适度的,在补充超过 2 个月后消失,这表明它可能是时间/剂量依赖性和饱和性的。

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