Zhang Yujing, Xue Yuan, Zhang Dongdong, Liu Yaping, Xu Ze, Gao Jiaojiao, Li Wenjie, Li Xing
College of Public Health, Zhengzhou University, Zhenghzou 450000, China.
Nutrients. 2021 Dec 14;13(12):4464. doi: 10.3390/nu13124464.
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.
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。