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维生素 D 在糖尿病患者炎症中作用的系统评价概述及其在 COVID-19 糖尿病患者中应用的潜力。

An Overview of Systematic Reviews of the Role of Vitamin D on Inflammation in Patients with Diabetes and the Potentiality of Its Application on Diabetic Patients with COVID-19.

机构信息

Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, 90127 Palermo, Italy.

Eurocenter Venalinfa, 63074 San Benedetto del Tronto, Italy.

出版信息

Int J Mol Sci. 2022 Mar 6;23(5):2873. doi: 10.3390/ijms23052873.

Abstract

Almost two years have passed since the outbreak reported for the first time in Wuhan of coronavirus disease 2019 (COVID-19), due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus, rapidly evolved into a pandemic. This infectious disease has stressed global health care systems. The mortality rate is higher, particularly in elderly population and in patients with comorbidities such as hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease, chronic renal disease, and malignancy. Among them, subjects with diabetes have a high risk of developing severe form of COVID-19 and show increased mortality. How diabetes contributes to COVID-19 severity remains unclear. It has been hypothesized that it may be correlated with the effects of hyperglycemia on systemic inflammatory responses and immune system dysfunction. Vitamin D (VD) is a modulator of immune-response. Data from literature showed that vitamin D deficiency in COVID-19 patients increases COVID-19 severity, likely because of its negative impact on immune and inflammatory responses. Therefore, the use of vitamin D might play a role in some aspects of the infection, particularly the inflammatory state and the immune system function of patients. Moreover, a piece of evidence highlighted a link among vitamin D deficiency, obesity and diabetes, all factors associated with COVID-19 severity. Given this background, we performed an overview of the systematic reviews to assess the association between vitamin D supplementation and inflammatory markers in patients with diabetes; furthermore, vitamin D's possible role in COVID-19 patients was assessed as well. Three databases, namely MEDLINE, PubMed Central and the Cochrane Library of Systematic Reviews, were reviewed to retrieve the pertinent data. The aim of this review is to provide insight into the recent advances about the molecular basis of the relationship between vitamin D, immune response, inflammation, diabetes and COVID-19.

摘要

自 2019 年新型冠状病毒病(COVID-19)首次在武汉报道以来,已经过去了近两年,这种疾病是由严重急性呼吸系统综合征(SARS)-CoV-2 冠状病毒引起的,迅速演变成了一种大流行。这种传染病给全球的医疗保健系统带来了巨大压力。其死亡率较高,特别是在老年人群和患有高血压、糖尿病、心血管疾病、慢性肺病、慢性肾病和恶性肿瘤等合并症的患者中。其中,糖尿病患者患 COVID-19 严重型的风险较高,死亡率也更高。然而,糖尿病如何导致 COVID-19 加重的机制尚不清楚。据推测,这可能与高血糖对全身炎症反应和免疫系统功能障碍的影响有关。维生素 D(VD)是免疫反应的调节剂。文献数据表明,COVID-19 患者的维生素 D 缺乏会增加 COVID-19 的严重程度,这可能是因为它对免疫和炎症反应产生了负面影响。因此,维生素 D 的使用可能在感染的某些方面发挥作用,特别是在患者的炎症状态和免疫系统功能方面。此外,有证据表明维生素 D 缺乏、肥胖和糖尿病之间存在关联,这些都是与 COVID-19 严重程度相关的因素。鉴于此,我们对系统评价进行了综述,以评估糖尿病患者补充维生素 D 与炎症标志物之间的关联;此外,还评估了维生素 D 在 COVID-19 患者中的可能作用。我们查阅了 MEDLINE、PubMed Central 和 Cochrane 系统评价数据库,以检索相关数据。本综述的目的是提供有关维生素 D、免疫反应、炎症、糖尿病和 COVID-19 之间关系的分子基础的最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a31/8911457/d85a12324894/ijms-23-02873-g001.jpg

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