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糖尿病前期和胰岛素抵抗:维生素 D 的作用。

Prediabetes and insulin resistance: effect of vitamin D.

机构信息

Division of Endocrinology and Diabetes, Internal Medicine, Shinkomonji Hospital, Kitakyushu, Japan.

出版信息

Curr Opin Clin Nutr Metab Care. 2024 Nov 1;27(6):509-514. doi: 10.1097/MCO.0000000000001070. Epub 2024 Aug 26.

Abstract

PURPOSE OF REVIEW

The impact of vitamin D on improving insulin resistance in prediabetes remains controversial. The purpose of this review is to examine whether vitamin D supplementation improves insulin resistance in adults with prediabetes, and if so, to identify the mechanisms and the specific populations.

RECENT FINDINGS

Global prevalence of prediabetes is increasing, and prevention is a critical issue because these people with prediabetes will develop type 2 diabetes soon, which will put pressure on healthcare costs. Recent evidence on the effectiveness of vitamin D administration in improving insulin resistance and preventing the onset of type 2 diabetes in adults with prediabetes has been accumulating. The 2024 updated clinical practice guideline of the American Diabetes Association states that vitamin D administration to patients with prediabetes potentially benefits type 2 diabetes incidence in specific populations. There are also reports that vitamin D administration improves insulin resistance via increased serum osteocalcin levels, a marker of bone turnover.

SUMMARY

Vitamin D is likely to improve insulin resistance, which is already present at the time of prediabetes. However, the effectiveness may vary depending on ethnic differences and blood vitamin D levels at the start of administration.

摘要

目的综述

维生素 D 对改善糖尿病前期患者胰岛素抵抗的影响仍存在争议。本综述旨在探讨维生素 D 补充是否能改善糖尿病前期成年人的胰岛素抵抗,如果能,那么其作用机制和具体适用人群是什么。

最近的发现

全球糖尿病前期的患病率正在上升,预防是一个关键问题,因为这些糖尿病前期患者很快就会发展为 2 型糖尿病,这将给医疗保健成本带来压力。最近有证据表明,维生素 D 治疗可改善糖尿病前期成年人的胰岛素抵抗,预防 2 型糖尿病的发生。美国糖尿病协会 2024 年更新的临床实践指南指出,维生素 D 治疗可能使特定人群的 2 型糖尿病发病率获益。也有报道称,维生素 D 通过增加骨转换标志物血清骨钙素水平来改善胰岛素抵抗。

总结

维生素 D 可能改善糖尿病前期患者已经存在的胰岛素抵抗。然而,其疗效可能因种族差异和治疗开始时的血维生素 D 水平而有所不同。

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