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维生素D补充剂对糖尿病前期血糖控制的影响:一项荟萃分析。

Effect of Vitamin D Supplementation on Glycemic Control in Prediabetes: A Meta-Analysis.

作者信息

Zhang Yujing, Xue Yuan, Zhang Dongdong, Liu Yaping, Xu Ze, Gao Jiaojiao, Li Wenjie, Li Xing

机构信息

College of Public Health, Zhengzhou University, Zhenghzou 450000, China.

出版信息

Nutrients. 2021 Dec 14;13(12):4464. doi: 10.3390/nu13124464.

Abstract

Clinical research results of vitamin D supplementation in the improvement of prediabetes remain controversial. Accordingly, a literature search was conducted of PubMed, Embase (Ovid), and Web of Science prior to 9 November 2021. Randomized controlled studies reported that the following indicators were included: body mass index (BMI), fasting blood glucose (FBG), 2 h oral glucose tolerance test plasma glucose (2h-PG), hemoglobin A1c (HbA1c), insulin resistance by homeostasis model assessment (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B), and fasting insulin (FINS). Twenty-nine articles ( = 3792) were included in the present meta-analysis. Intriguingly, vitamin D supplementation resulted in a vast improvement in FBG (standardized mean difference (SMD) = -0.38; 95%CI: -0.59, -0.16), HbA1c (SMD = -0.14; 95%CI: -0.22, -0.06) and FINS (SMD = 0.18; 95%CI: -0.26, -0.09), but not in other outcomes. However, preferred changes were observed in subgroups, as follows: Asia (SMD = -0.25, 95%CI: -0.45, -0.04), study duration ≥1 year (SMD = -0.44, 95%CI: -0.81, -0.06) (SMD = 0.34, 95%CI: 0.01, 0.66), baseline 25(OH)D < 50 nmol/L (SMD = -0.23, 95%CI: -0.39, -0.06), and baseline 25(OH)D ≥ 50 nmol/L (SMD = -0.50, 95%CI: -0.96, -0.03). In conclusion, oral supplementation of vitamin D has shown better effects in improving FBG, HbA1c, and FINS compared with controls among prediabetics; long-term vitamin D supplementation could have additional effects in participants with vitamin D deficiency for 2h-PG, HOMA-IR, and HOMA-B.

摘要

补充维生素D改善糖尿病前期的临床研究结果仍存在争议。因此,在2021年11月9日前对PubMed、Embase(Ovid)和Web of Science进行了文献检索。随机对照研究报告纳入了以下指标:体重指数(BMI)、空腹血糖(FBG)、口服葡萄糖耐量试验2小时血糖(2h-PG)、糖化血红蛋白(HbA1c)、稳态模型评估胰岛素抵抗(HOMA-IR)、稳态模型评估β细胞功能(HOMA-B)和空腹胰岛素(FINS)。本荟萃分析纳入了29篇文章(n = 3792)。有趣的是,补充维生素D使FBG(标准化均数差(SMD)=-0.38;95%CI:-0.59,-0.16)、HbA1c(SMD=-0.14;95%CI:-0.22,-0.06)和FINS(SMD = 0.18;95%CI:-0.26,-0.09)有显著改善,但对其他指标无改善。然而,在亚组中观察到了更优变化,如下:亚洲(SMD=-0.25,95%CI:-0.45,-0.04)、研究持续时间≥1年(SMD=-0.44,95%CI:-0.81,-0.06)(SMD = 0.34,95%CI:0.01,0.66)、基线25(OH)D<50 nmol/L(SMD=-0.23,95%CI:-0.39,-0.06)以及基线25(OH)D≥50 nmol/L(SMD=-0.50,95%CI:-0.96,-0.03)。总之,与对照组相比,口服补充维生素D在改善糖尿病前期患者的FBG、HbA1c和FINS方面显示出更好的效果;长期补充维生素D可能对维生素D缺乏的参与者在2h-PG、HOMA-IR和HOMA-B方面有额外作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51dd/8707376/8e5a249cf557/nutrients-13-04464-g001.jpg

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