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单次剂量胆钙化醇对 2 型糖尿病、高血压和维生素 D 缺乏症患者血压的影响。

Efficacy of single-dose cholecalciferol in the blood pressure of patients with type 2 diabetes, hypertension and hypovitaminoses D.

机构信息

Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Prédio 12, 4º andar, Porto Alegre, RS, 90035-003, Brazil.

Postgraduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Sci Rep. 2020 Nov 12;10(1):19611. doi: 10.1038/s41598-020-76646-6.

Abstract

Observational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension. We investigated the effect of a single dose of 100,000 IU of cholecalciferol, in office blood pressure (BP), and 24-h ambulatory blood pressure monitoring (ABPM) in patients with type 2 diabetes mellitus (DM), hypertension, and hypovitaminosis D. Forty-three patients were randomized to a placebo or cholecalciferol group. BP was assessed by office measurements and 24-h ABPM, before and after intervention. At week 8, a greater decrease in median ABPM values was observed in cholecalciferol supplementation than in the placebo group for systolic 24-h (- 7.5 vs. - 1; P = 0.02), systolic daytime (- 7 vs. - 1; P = 0.007), systolic nighttime (- 7.0 vs. 3; P = 0.009), diastolic 24-h (- 3.5 vs. - 1; P = 0.037), and daytime DBP (- 5 vs. 0; P = 0.01). Office DBP was also reduced after vitamin D supplementation. A single dose of vitamin D improves BP in patients with type 2 diabetes, hypertension, and vitamin D insufficiency, regardless of vitamin D normalization. Vitamin D supplementation could be a valuable tool to treat patients with type 2 DM, hypertension, and hypovitaminosis D.Trial registration: Clinicaltrials.gov NCT02204527.

摘要

观察性和实验数据强化了维生素 D 与动脉高血压发病机制相关的概念。我们研究了单次给予 100000IU 胆钙化醇对 2 型糖尿病(DM)、高血压和维生素 D 缺乏症患者的诊室血压(BP)和 24 小时动态血压监测(ABPM)的影响。43 名患者被随机分配至安慰剂或胆钙化醇组。在干预前后通过诊室测量和 24 小时 ABPM 评估 BP。在第 8 周时,与安慰剂组相比,胆钙化醇组的 24 小时收缩压(-7.5 与-1;P=0.02)、日间收缩压(-7 与-1;P=0.007)、夜间收缩压(-7.0 与 3;P=0.009)、24 小时舒张压(-3.5 与-1;P=0.037)和日间舒张压(-5 与 0;P=0.01)的中位数 ABPM 值下降幅度更大。补充胆钙化醇后诊室舒张压也降低。单次剂量的维生素 D 可改善 2 型糖尿病、高血压和维生素 D 不足患者的血压,而与维生素 D 正常化无关。维生素 D 补充可能是治疗 2 型 DM、高血压和维生素 D 缺乏症患者的有效工具。试验注册:Clinicaltrials.gov NCT02204527。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c95/7665034/ea83ee719825/41598_2020_76646_Fig1_HTML.jpg

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