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。