Department of General and Specialty Medicine, Division of Endocrinology, Diabetology and Metabolic Diseases, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy.
J Endocrinol Invest. 2021 Apr;44(4):791-802. doi: 10.1007/s40618-020-01373-8. Epub 2020 Aug 17.
Hypovitaminosis D has been associated with many cardio-metabolic disorders, although their pathogenetic link still remains unclear. Our aim was to evaluate whether 1-year vitamin D (D) supplementation could improve glycemic control, lipid profile, systolic (SBP) and diastolic (DBP) blood pressure levels and body composition.
In an open-label randomized-controlled pilot study, thirty poor-controlled (HbA1c > 59 mmol/mol) type 2 diabetic patients (age 71.5 ± 3.2 years, M/F 21/9, BMI 29.8 ± 3.6 kg/m) with hypovitaminosis D (25OHD 22.0 ± 11.3 nmol/l) were randomized to cholecalciferol supplementation (500 UI/kg p.o. weekly, + D) or observation (- D) for one year. Changes in parameters of glucose, lipid and blood pressure control at 3, 6, 9 and 12 months vs. baseline were assessed.
One-year D supplementation restored D status and had a beneficial effect on fasting glucose (FG, mean percentage changes ± SD, - 1.8% ± 23.1 vs. + 18.8% ± 30.0), glycosylated haemoglobin (HbA1c, - 13.7% ± 14.5 vs. - 4.2% ± 14.1), SBP (- 13.4% ± 8.5 vs. - 2.4% ± 12.6) and HDL-cholesterol levels (- 2.1% ± 14.0 vs. - 10.9% ± 12.9; p < 0.05 for all comparisons) in + D vs. - D patients, respectively. In the former, a reduction in HBA1c, SBP and DBP levels, BMI, fat mass index (FMI) and ratio (FMR) was observed after 1 year (p < 0.05 for all comparisons vs. baseline). We noticed a relationship between 1-year mean percentage changes of serum 25OHD and SBP levels (R = - 0.36, p < 0.05).
One-year cholecalciferol supplementation, able to restore D status, significantly improves FG, HbA1c, SBP and HDL-cholesterol levels in patients with poor-controlled type 2 diabetes mellitus and D deficiency.
维生素 D 缺乏与许多心血管代谢紊乱有关，尽管其发病机制仍不清楚。我们的目的是评估 1 年维生素 D（D）补充是否可以改善血糖控制、血脂谱、收缩压（SBP）和舒张压（DBP）血压水平和身体成分。
在一项开放标签、随机对照的初步研究中，我们将 30 名血糖控制不佳（HbA1c>59mmol/mol）的 2 型糖尿病患者（年龄 71.5±3.2 岁，M/F 21/9，BMI 29.8±3.6kg/m2）分为维生素 D 缺乏症（25OHD 22.0±11.3nmol/l）患者随机分为胆钙化醇补充组（500UI/kg 口服，每周一次，+D）或观察组（-D），为期 1 年。评估 3、6、9 和 12 个月与基线相比血糖、血脂和血压控制参数的变化。
1 年 D 补充恢复了 D 状态，并对空腹血糖（FG，平均百分比变化±SD，-1.8%±23.1 与+18.8%±30.0）、糖化血红蛋白（HbA1c，-13.7%±14.5 与-4.2%±14.1）、SBP（-13.4%±8.5 与-2.4%±12.6）和高密度脂蛋白胆固醇水平（-2.1%±14.0 与-10.9%±12.9；所有比较均 p<0.05）有有益的影响。在+D 患者中，与-D 患者相比，分别观察到 FG、HbA1c、SBP 和 HDL-胆固醇水平分别下降 13.7%±14.5%、-13.4%±8.5%、-13.4%±8.5%和-13.4%±8.5%（所有比较均 p<0.05）。在前者中，1 年后观察到 HBA1c、SBP 和 DBP 水平、BMI、脂肪质量指数（FMI）和比值（FMR）下降（与基线相比，所有比较均 p<0.05）。我们注意到 1 年血清 25OHD 的平均百分比变化与 SBP 水平之间存在关系（R=-0.36，p<0.05）。
1 年胆钙化醇补充可恢复 D 状态，显著改善血糖控制不佳的 2 型糖尿病患者的 FG、HbA1c、SBP 和 HDL-胆固醇水平，以及 D 缺乏症患者的 FG、HbA1c、SBP 和 HDL-胆固醇水平。
