Internal Medicine Residency Program, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia.
Gastroenterohepatology Division, Department of Internal Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia.
Sci Rep. 2022 May 11;12(1):7716. doi: 10.1038/s41598-022-11950-x.
Insulin resistance provides an important role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Several studies already evaluate vitamin D supplementation for NAFLD patients in relation to insulin resistance. The results obtained still carry conflicting results. This study aimed to evaluate the effect of additional treatment of vitamin D for the improvement of insulin resistance in NAFLD patients. Relevant literatures were obtained from PubMed, Google Scholar, COCHRANE, and Science Direct database. The obtained studies were analyzed using fixed effect model or random effect model. Seven eligible studies with a total of 735 participants were included. Vitamin D supplementation improves insulin resistance in NAFLD patients, marked by reduced Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), with pooled mean difference - 1.06 (p = 0.0006; 95% CI - 1.66 to - 0.45). Vitamin D supplementation increase the level of vitamin D serum with pooled mean difference of 17.45 (p = 0.0002; 95% CI 8.33 to 26.56). Vitamin D supplementation decrease ALT levels, with pooled mean difference of - 4.44 (p = 0.02; 95% CI - 8.24 to - 0.65). No effect was observed for AST levels. Vitamin D supplementation provides beneficial effects on the improvement of insulin resistance in NAFLD patients. This supplementation may reduce HOMA-IR in such patients. It may serve as a potential adjunctive treatment for NAFLD patients.
胰岛素抵抗在非酒精性脂肪性肝病(NAFLD)的发病机制中起着重要作用。已有几项研究评估了维生素 D 补充剂对 NAFLD 患者胰岛素抵抗的影响。但得到的结果仍存在矛盾。本研究旨在评估额外补充维生素 D 对改善 NAFLD 患者胰岛素抵抗的作用。从 PubMed、Google Scholar、COCHRANE 和 Science Direct 数据库中获取相关文献。使用固定效应模型或随机效应模型分析获得的研究。共纳入 7 项符合条件的研究,共 735 名参与者。维生素 D 补充可改善 NAFLD 患者的胰岛素抵抗,表现为稳态模型评估的胰岛素抵抗(HOMA-IR)降低,合并均数差为-1.06(p=0.0006;95%CI-1.66 至-0.45)。维生素 D 补充可增加血清维生素 D 水平,合并均数差为 17.45(p=0.0002;95%CI8.33 至 26.56)。维生素 D 补充可降低 ALT 水平,合并均数差为-4.44(p=0.02;95%CI-8.24 至-0.65)。AST 水平无变化。维生素 D 补充对改善 NAFLD 患者的胰岛素抵抗有有益作用。这种补充可能会降低此类患者的 HOMA-IR。它可能是 NAFLD 患者的一种潜在辅助治疗方法。