Institute of Nutrition & Health, Qingdao University, Qingdao, China.
Food Funct. 2020 Sep 23;11(9):7389-7399. doi: 10.1039/d0fo01095b.
The results of randomized controlled trials (RCTs) investigating supplemental vitamin D on aminotransferases and cardio-metabolic risk factors in subjects with non-alcoholic fatty liver disease (NAFLD) have been inconsistent. The present study aimed to quantitatively evaluate whether supplementation with vitamin D has beneficial effects in treatment of NAFLD. A systematical literature search was performed with Cochrane Library, PubMed, Scopus databases and Web of Science up to June 2020. The mean changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride (TAG) were calculated as standard mean difference (SMD) using a random-effects model. Pre-specified subgroup and univariate meta-regression analyses were performed to identify the sources of heterogeneity. Ten trials with a total of 544 NAFLD subjects were included for data synthesis. The summary estimates indicated that supplemental vitamin D significantly reduced the levels of serum/plasma fasting glucose (-0.22; 95%CI: -0.39, -0.04), insulin (-0.68; 95%CI: -1.22, -0.14) and HOMA-IR (-1.32; 95%CI: -2.30, -0.34), and marginally reduced the ALT (-0.18; 95%CI: -0.39, 0.04) and TAG (-10.38; 95%CI: -21.09, 0.34) levels. However, the pooled effect did not support that supplemental vitamin D was beneficial for concentrations of AST, TC, HDL-C and LDL-C. The present study provides substantial evidence that supplemental vitamin D has favorable effects on glycemic control and insulin sensitivity in NAFLD patients. Vitamin D could be as an adjuvant pharmacotherapy of NAFLD.
随机对照试验（RCTs）的结果表明，补充维生素 D 对非酒精性脂肪性肝病（NAFLD）患者的氨基转移酶和心血管代谢危险因素的影响并不一致。本研究旨在定量评估补充维生素 D 对治疗 NAFLD 是否有益。系统检索了 Cochrane 图书馆、PubMed、Scopus 数据库和 Web of Science，检索时间截至 2020 年 6 月。采用随机效应模型计算丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、空腹血糖、胰岛素、稳态模型评估胰岛素抵抗（HOMA-IR）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TAG）的平均变化值作为标准均数差（SMD）。进行了预先指定的亚组和单变量荟萃回归分析，以确定异质性的来源。纳入了 10 项试验，共 544 例 NAFLD 患者的数据进行了综合分析。汇总估计表明，补充维生素 D 可显著降低血清/血浆空腹血糖（-0.22；95%CI：-0.39，-0.04）、胰岛素（-0.68；95%CI：-1.22，-0.14）和 HOMA-IR（-1.32；95%CI：-2.30，-0.34）水平，且轻度降低 ALT（-0.18；95%CI：-0.39，0.04）和 TAG（-10.38；95%CI：-21.09，0.34）水平。然而，汇总效应并不支持补充维生素 D 对 AST、TC、HDL-C 和 LDL-C 浓度有益。本研究提供了充分的证据表明，补充维生素 D 对 NAFLD 患者的血糖控制和胰岛素敏感性有良好的作用。维生素 D 可能是 NAFLD 的辅助药物治疗。
