Ahmed Munibuddin M, Zingade Urjita S, Badaam Khaled M
Physiology, Government Medical College, Aurangabad, IND.
Physiology, Rajarshi Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, IND.
Cureus. 2020 Dec 10;12(12):e12009. doi: 10.7759/cureus.12009.
Introduction The interplay of vitamin D and glucose metabolism is an area of ongoing research. The need for vitamin D supplementation trials in individuals with prediabetes and hypovitaminosis D has been stressed by earlier research studies. The objective of this study was to assess the effect of vitamin D3 supplementation on oral glucose insulin sensitivity (OGIS) index in patients with prediabetes and hypovitaminosis D. Methods We enrolled 120 individuals with prediabetes (ADA definition) and hypovitaminosis D (vitamin D < 30 ng/mL) and randomized them into the vitamin D supplementation (60,000 IU weekly) group and the placebo group. Primary outcome measure (i.e., 2-hour OGIS index) and secondary outcome measures (i.e., fasting and postprandial blood glucose, glycosylated hemoglobin, body mass index, and insulin sensitivity indices, i.e., quantitative insulin sensitivity check index [QUICKI] and homeostatic model assessment for insulin resistance [HOMA-IR]) were analyzed for change with the 12 weeks of intervention. Results A total of 52 subjects in the vitamin D group and 49 in the placebo group completed the study. Serum vitamin D levels (10.11 ± 2.73 to 52.2 ± 13.14 ng/mL; p < 0.0001) and OGIS index (376.4 ± 39.7 to 391.7 ± 40.7 mL/min/m; p = 0.011) increased significantly on per-protocol analysis in the vitamin D group. There was no significant change observed in vitamin D levels and OGIS index in the placebo group. Between-group comparison showed a rise in OGIS index (15.3 ± 47.1 mL/min/m) in the vitamin D group and decrease in OGIS index (-10.4 ± 44.7 mL/min/m) in the placebo group, and the difference was statistically significant (p = 0.0029). The inter-group comparison showed relative fall in fasting glucose levels in the vitamin D group, with no significant change observed in the other secondary outcome measures. Conclusions The correction of hypovitaminosis D in subjects with prediabetes led to improved insulin sensitivity as assessed by OGIS index at 120 minutes, signifying the role of vitamin D in glucose homeostasis.
引言 维生素D与葡萄糖代谢之间的相互作用是一个正在进行研究的领域。早期研究强调了对糖尿病前期和维生素D缺乏症患者进行维生素D补充试验的必要性。本研究的目的是评估补充维生素D3对糖尿病前期和维生素D缺乏症患者口服葡萄糖胰岛素敏感性（OGIS）指数的影响。方法 我们招募了120名糖尿病前期（根据美国糖尿病协会定义）和维生素D缺乏症（维生素D<30 ng/mL）患者，并将他们随机分为维生素D补充组（每周60,000 IU）和安慰剂组。分析主要结局指标（即2小时OGIS指数）和次要结局指标（即空腹和餐后血糖、糖化血红蛋白、体重指数以及胰岛素敏感性指数，即定量胰岛素敏感性检查指数[QUICKI]和胰岛素抵抗稳态模型评估[HOMA-IR]）在12周干预后的变化。结果 维生素D组共有52名受试者，安慰剂组有49名受试者完成了研究。按方案分析，维生素D组的血清维生素D水平（从10.11±2.73 ng/mL升至52.2±13.14 ng/mL；p<0.0001）和OGIS指数（从376.4±39.7 mL/min/m升至391.7±40.7 mL/min/m；p = 0.011）显著升高。安慰剂组的维生素D水平和OGIS指数未观察到显著变化。组间比较显示，维生素D组的OGIS指数升高（15.3±47.1 mL/min/m），安慰剂组的OGIS指数降低（-10.4±44.7 mL/min/m），差异具有统计学意义（p = 0.0029）。组间比较显示维生素D组的空腹血糖水平相对下降，其他次要结局指标未观察到显著变化。结论 糖尿病前期患者维生素D缺乏症的纠正导致120分钟时通过OGIS指数评估的胰岛素敏感性提高，这表明维生素D在葡萄糖稳态中的作用。
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