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维生素 D 补充对 2 型糖尿病患者血糖控制和心血管危险因素的影响:临床试验的更新系统评价和荟萃分析。

The Effect of Vitamin D Supplementation on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis of Clinical Trials.

机构信息

Student Research Committee Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran.

Department of Physical Medicine and Rehabilitation Hamedan University of Medical Sciences, Hamedan, Iran.

出版信息

J Diabetes Res. 2024 Sep 10;2024:9960656. doi: 10.1155/2024/9960656. eCollection 2024.


DOI:10.1155/2024/9960656
PMID:39290798
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11407890/
Abstract

The purpose of this meta-analysis was to investigate the effect of vitamin D supplementation on hemoglobin A1C (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and the total vitamin D level in patients with Type 2 diabetes (T2DM). A systematic search was conducted in databases such as PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov using relevant keywords from January 1990 to January 2024. After screening and extracting data, a qualitative evaluation of articles was performed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). The findings revealed that vitamin D supplementation significantly decreased the mean HbA1C (SMD: -0.15; 95% CI: -0.29, -0.20; : 79.76%; value < 0.001) and mean FBS (SMD: -0.28; 95% CI: -0.40, -0.15; : 70.13%; value < 0.001), lowered SBP (SMD: -0.06; 95% CI: -0.16, -0.05; : 39.63%; value = 0.23), and reduced LDL (SMD: -0.11; 95% CI: -0.28, -0.05; : 73.66%; value < 0.001). Furthermore, vitamin D supplementation increased the average HDL (SMD: 0.13; 95% CI: 0.04, 0.29; : 79.33%; value < 0.001) and vitamin D levels (SMD: 1.78; 95% CI: 1.53, 2.04; : 91.92%; value < 0.001) in patients with T2DM. Subgroup analyses showed that weight gain, BMI, and duration of the disease could reduce the effect of vitamin D supplementation on diabetes control in affected patients. The results also indicated that taking vitamin D supplements in the amount of 50,000 IU had a significant effect on reducing the indicators related to diabetes control. Based on the combined evidence, the findings of this meta-analysis suggest that vitamin D supplementation can significantly improve glycemic control and reduce the risk of complications associated with T2DM, especially cardiovascular diseases (CVDs).

摘要

这项荟萃分析的目的是研究维生素 D 补充对 2 型糖尿病(T2DM)患者的血红蛋白 A1C(HbA1C)、空腹血糖(FBS)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、收缩压(SBP)和总维生素 D 水平的影响。通过使用 1990 年 1 月至 2024 年 1 月期间的相关关键字,在 PubMed(Medline)、Scopus、Embase、Web of Science、Cochrane 图书馆和 ClinicalTrials.gov 等数据库中进行了系统搜索。经过筛选和数据提取,使用 Cochrane 随机试验偏倚风险工具(RoB 2)对文章进行了定性评估。研究结果表明,维生素 D 补充显著降低了平均 HbA1C(SMD:-0.15;95%CI:-0.29,-0.20; :79.76%; 值<0.001)和平均 FBS(SMD:-0.28;95%CI:-0.40,-0.15; :70.13%; 值<0.001),降低了 SBP(SMD:-0.06;95%CI:-0.16,-0.05; :39.63%; 值=0.23),并降低了 LDL(SMD:-0.11;95%CI:-0.28,-0.05; :73.66%; 值<0.001)。此外,维生素 D 补充增加了平均 HDL(SMD:0.13;95%CI:0.04,0.29; :79.33%; 值<0.001)和维生素 D 水平(SMD:1.78;95%CI:1.53,2.04; :91.92%; 值<0.001)在 T2DM 患者中。亚组分析表明,体重增加、BMI 和疾病持续时间会降低维生素 D 补充对糖尿病患者的控制效果。结果还表明,服用 50,000 IU 维生素 D 补充剂对降低与糖尿病控制相关的指标有显著效果。基于综合证据,这项荟萃分析的结果表明,维生素 D 补充可以显著改善血糖控制,降低与 T2DM 相关的并发症风险,特别是心血管疾病(CVDs)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/726b5b8f6a11/JDR2024-9960656.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/00a181264e41/JDR2024-9960656.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/17df6e386395/JDR2024-9960656.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/726b5b8f6a11/JDR2024-9960656.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/00a181264e41/JDR2024-9960656.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/17df6e386395/JDR2024-9960656.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4f/11407890/726b5b8f6a11/JDR2024-9960656.003.jpg

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本文引用的文献

[1]
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[2]
Effect of vitamin D supplementation on type 2 diabetes biomarkers: an umbrella of interventional meta-analyses.

Diabetol Metab Syndr. 2023-4-19

[3]
Circulating microRNAs as potential biomarkers of early vascular damage in vitamin D deficiency, obese, and diabetic patients.

PLoS One. 2023

[4]
Controversial Impact of Vitamin D Supplementation on Reducing Insulin Resistance and Prevention of Type 2 Diabetes in Patients with Prediabetes: A Systematic Review.

Nutrients. 2023-2-16

[5]
Effect of vitamin E intake on glycemic control and insulin resistance in diabetic patients: an updated systematic review and meta-analysis of randomized controlled trials.

Nutr J. 2023-2-17

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Nutrients. 2023-2-2

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Nutrients. 2023-1-20

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What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails.

BMC Endocr Disord. 2023-1-16

[9]
Effects of long-term vitamin D supplementation on metabolic profile in middle-aged and elderly patients with type 2 diabetes.

J Steroid Biochem Mol Biol. 2023-1

[10]
Comparison of nutritional supplements for glycemic control in type 2 diabetes: A systematic review and network meta-analysis of randomized trials.

Diabetes Res Clin Pract. 2022-9

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