维生素 D3 对重症骨关节炎患者糖代谢的影响：每日 2000IU 与 800IU 维生素 D3 对比的随机双盲试验。

Effects of vitamin D3 on glucose metabolism in patients with severe osteoarthritis: A randomized double-blind trial comparing daily 2000 with 800 IU vitamin D3.

机构信息

Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid&Triemli and University of Zurich, Zurich, Switzerland.

Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.

出版信息

Diabetes Obes Metab. 2021 Apr;23(4):1011-1019. doi: 10.1111/dom.14307. Epub 2021 Jan 19.

DOI:10.1111/dom.14307

PMID:33368963

Abstract

AIM

To investigate the effect of daily 800 versus 2000 IU of vitamin D3 supplementation over 24 months on glycaemic control in older adults after unilateral knee replacement.

MATERIALS AND METHODS

The Zurich Multiple Endpoint Vitamin D Trial in Knee OA Patients was a randomized, double-blind trial conducted from 2008 to 2014 in Zurich, Switzerland. Participants were randomly allocated to 800 or 2000 IU vitamin D3 daily for 24 months. This study investigates the predefined secondary endpoints of fasting blood glucose (FBG) and homeostatic model assessment for insulin resistance (HOMA-IR) using linear mixed models adjusted for age, sex, baseline vitamin D deficiency and body mass index.

RESULTS

A total of 251 participants (age 70.2 ± 6.5 years; 55.4% women; 39% impaired glucose tolerance, mean 25-hydroxyvitamin D 27.48 ± 12.48 ng/mL, mean FBG 5.49 ± 0.71 mmol/L) were included in this analysis. There was no significant difference in FBG between the group receiving 800 versus 2000 IU after 2 years with a least square mean (95% CI) of 5.32 (5.19; 5.44) versus 5.39 (5.27; 5.51) mmol/L (p = .130) and no difference in HOMA-IR (0.44 [0.37; 0.52] vs. 0.49 [0.41; 0.58]; p = .162), respectively. However, FBG decreased significantly over time independent of vitamin D3 dose (800 IU: 5.54 [5.42; 5.66] to 5.32 [5.19; 5.44], p < .001; 2000 IU: 5.5 [5.38; 5.62] to 5.39 [5.27; 5.51] mmol/L, p = .019).

CONCLUSIONS

There was no clinically meaningful difference between 800 and 2000 IU of vitamin D3 over 2 years in FBG or HOMA-IR in community-dwelling older adults. Glycaemic outcomes improved in both groups.

摘要

目的

研究在单侧膝关节置换术后 24 个月内，每日补充 800 或 2000IU 维生素 D3 对老年人血糖控制的影响。

材料和方法

苏黎世膝关节骨关节炎患者的多维终点维生素 D 试验是一项 2008 年至 2014 年在瑞士苏黎世进行的随机、双盲试验。参与者被随机分配每日接受 800 或 2000IU 维生素 D3 治疗 24 个月。本研究使用线性混合模型调整年龄、性别、基线维生素 D 缺乏和体重指数，调查空腹血糖（FBG）和稳态模型评估的胰岛素抵抗（HOMA-IR）这两个预先设定的次要终点。

结果

共有 251 名参与者（年龄 70.2±6.5 岁；55.4%女性；39%葡萄糖耐量受损，平均 25-羟维生素 D 为 27.48±12.48ng/mL，平均 FBG 为 5.49±0.71mmol/L）纳入本分析。两组患者在 2 年内的 FBG 无显著差异，最低平方均值（95%CI）分别为 5.32（5.19；5.44）mmol/L 和 5.39（5.27；5.51）mmol/L（p=0.130），HOMA-IR 也无差异（0.44[0.37；0.52]vs.0.49[0.41；0.58]；p=0.162）。然而，FBG 随时间显著下降，与维生素 D3 剂量无关（800IU：5.54[5.42；5.66]降至 5.32[5.19；5.44]mmol/L，p<0.001；2000IU：5.5[5.38；5.62]降至 5.39[5.27；5.51]mmol/L，p=0.019）。