Zou Yutong, Guo Bo, Yu Songlin, Wang Danchen, Qiu Ling, Jiang Yu
Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
J Clin Biochem Nutr. 2021 Nov;69(3):229-237. doi: 10.3164/jcbn.20-165. Epub 2021 May 7.
Objective of the present study was to evaluate the effect of vitamin D supplementation on glycose homeostasis, islet function, and diabetes progress. Literatures were searched via electronic databases, websites, and previous reviews from the earliest available time to the end of May 2020. Randomized controlled trials initially designed for diabetes and prediabetes with 25-dihydroxyvitamin D [25(OH)D]<30 ng/ml were included. All data were analyzed and presented based on the Cochrane guidelines and PRISMA guidelines. In total, 27 articles ( = 1,932) were enrolled in this study. Vitamin D supplementation significantly improved fasting blood glucose, postprandial blood glucose, and quantitative insulin sensitivity check index in diabetes and prediabetes with baseline 25(OH)D<30 ng/ml. Higher percentages regressing from prediabetes to normal glucose status [1.60 (1.19, 2.17), = 0.002, = 564] and lower percentage progressing from prediabetes to diabetes [0.68 (0.36, 1.27), = 0.23, = 569] were found in the supplementation group. The positive effects of vitamin D supplementation on body mass index, waist, HDL-C, LDL-C, and CRP were also demonstrated. In conclusion, modest improvements in vitamin D supplementation on short-term glycose homeostasis, insulin sensitivity, and disease development in diabetes and prediabetes with 25(OH)D<30 ng/ml were demonstrated, but more research needs to be conducted in the future to support the clinical application. (Register ID: CRD42020186004).
本研究的目的是评估补充维生素D对血糖稳态、胰岛功能和糖尿病进展的影响。通过电子数据库、网站以及从最早可得时间至2020年5月底的既往综述检索文献。纳入最初设计用于糖尿病和糖尿病前期且25-二羟维生素D[25(OH)D]<30 ng/ml的随机对照试验。所有数据均根据Cochrane指南和PRISMA指南进行分析和呈现。本研究共纳入27篇文章（n=1932）。对于基线25(OH)D<30 ng/ml的糖尿病和糖尿病前期患者，补充维生素D显著改善了空腹血糖、餐后血糖和定量胰岛素敏感性检查指数。在补充组中，从糖尿病前期回归至正常血糖状态的比例更高[1.60(1.19, 2.17)，P=0.002，n=564]，而从糖尿病前期进展至糖尿病的比例更低[0.68(0.36, 1.27)，P=0.23，n=569]。补充维生素D对体重指数、腰围、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和C反应蛋白也有积极作用。总之，已证实对于25(OH)D<30 ng/ml的糖尿病和糖尿病前期患者，补充维生素D在短期血糖稳态、胰岛素敏感性和疾病发展方面有适度改善，但未来还需要更多研究来支持其临床应用。（注册号：CRD42020186004）
