Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Med Sci. 2023 Jan;48(1):4-12. doi: 10.30476/ijms.2021.90586.2166.
Progressive insulin resistance is a physiological condition during pregnancy that can lead to gestational diabetes. Given the association between low blood vitamin D levels and insulin resistance, the present meta-analysis evaluated the effect of vitamin D supplementation on serum 25-hydroxyvitamin D (25[OH]D) and the homeostatic model of insulin resistance (HOMA-IR) levels in non-diabetic pregnant women.
A comprehensive literature search was conducted using electronic databases and gateways such as Cochrane Library, Medline, Google Scholar, Science Direct, Web of Sciences, Embase, and Scopus. Articles up to 2020 in both English and Persian were included in the study. The effect of vitamin D supplementation on 25(OH)D and HOMA-IR was determined based on the differences in mean changes from baseline to post-intervention. Weighted mean and 95% confidence intervals (CI) were pooled using a random-effects model. Data were analyzed using STATA software.
Four studies, including six trials with 380 participants, reported that vitamin D supplementation increased 25(OH)D (mean change: 13.72, 95% CI: 7.28-20.17) and decreased HOMA-IR (mean change: 1.46, 95% CI: 0.56-2.37) levels compared with the placebo group. A high weekly dose of vitamin D further reduced HOMA-IR levels (adjusted R=77.99, I residuals=80.49%, P=0.047). There was no significant association between the dose of vitamin D and 25(OH)D (P=0.974). Intervention duration was not associated with an increase in 25(OH)D (P=0.102), nor with a decrease in HOMA-IR (P=0.623).
Vitamin D supplementation increased 25(OH)D and decreased HOMA-IR levels in non-diabetic pregnant women. Vitamin D in high doses further reduced HOMA-IR, but did not affect 25(OH)D concentrations.
进行性胰岛素抵抗是妊娠期间的一种生理状态，可导致妊娠期糖尿病。鉴于血液维生素 D 水平低与胰岛素抵抗之间存在关联，本荟萃分析评估了维生素 D 补充剂对非糖尿病孕妇血清 25-羟维生素 D（25[OH]D）和稳态模型胰岛素抵抗（HOMA-IR）水平的影响。
使用电子数据库和 Cochrane 图书馆、Medline、Google Scholar、Science Direct、Web of Sciences、Embase 和 Scopus 等门户，全面检索文献。纳入研究的文献为 2020 年以前发表的英文和波斯语文章。根据从基线到干预后的平均变化差异，确定维生素 D 补充剂对 25（OH）D 和 HOMA-IR 的影响。使用随机效应模型汇总加权均数和 95%置信区间（CI）。使用 STATA 软件进行数据分析。
四项研究包括六项试验，共有 380 名参与者，结果表明与安慰剂组相比，维生素 D 补充剂增加了 25（OH）D（平均变化：13.72，95%CI：7.28-20.17）和降低了 HOMA-IR（平均变化：1.46，95%CI：0.56-2.37）水平。高剂量每周维生素 D 进一步降低了 HOMA-IR 水平（调整后的 R=77.99，I 残差=80.49%，P=0.047）。维生素 D 剂量与 25（OH）D 之间无显著相关性（P=0.974）。干预持续时间与 25（OH）D 增加无关（P=0.102），与 HOMA-IR 降低无关（P=0.623）。
维生素 D 补充剂增加了非糖尿病孕妇的 25（OH）D 水平并降低了 HOMA-IR 水平。高剂量维生素 D 进一步降低了 HOMA-IR，但对 25（OH）D 浓度没有影响。
