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维生素D在2型糖尿病预防中的作用:一项系统评价与荟萃分析。

Role of vitamin D in prevention of type 2 diabetes mellitus: A systematic review and meta‑analysis.

作者信息

Sim Gyuri, Kim Yunjung, Lee Sun Min, Hahn Jongsung, Kim Jongyoon

机构信息

Department of Pharmacy, Dongduk Women's University, Seongbuk, Seoul 02748, Republic of Korea.

Department of Pharmacy, Jeonbuk National University, Jeonju, Jeollabuk 54896, Republic of Korea.

出版信息

Exp Ther Med. 2024 Oct 8;28(6):451. doi: 10.3892/etm.2024.12741. eCollection 2024 Dec.

Abstract

The escalating prevalence of diabetes mellitus, projected to affect over 700 million by 2045, underscores the urgent need for effective management and prevention strategies, with type 2 diabetes mellitus (T2DM) constituting over 90% of these cases globally. The present meta-analysis aims to rigorously evaluate the potential of vitamin D supplementation in mitigating the onset of T2DM, amidst the backdrop of its biological plausibility yet inconclusive evidence regarding its efficacy in reducing new incidences of the disease. A comprehensive literature search up to December 2023 in MEDLINE, EMBASE and the Cochrane Library, employing a strategy focused on diabetes and vitamin D, identified randomized controlled trials (RCTs) that explore the impact of vitamin D supplementation on T2DM onset in adults with impaired glucose regulation, incorporating quality assessment via the Cochrane ROB2 tool and utilizing meta-analysis with RevMan Web to evaluate effect magnitude and heterogeneity. In a meta-analysis of 11 RCTs with 5,221 prediabetic patients, vitamin D supplementation was associated with a 10% reduction in the progression to T2DM [RR, 0.90; 95% CI, (0.81-0.99)] and a significant increase in regression to normoglycemia [RR, 1.24; 95% CI, (1.08-1.43)], with no significant heterogeneity or publication bias observed. This meta-analysis of 11 RCTs shows that vitamin D supplementation in prediabetic patients lowers the risk of T2DM and promotes regression to normoglycemia, with no significant differences in subgroup analyses or interaction with baseline vitamin D levels, ethnicity, or body mass index (BMI). Despite indications from some trials that baseline vitamin D status may influence outcomes, the present comprehensive analysis found benefits of vitamin D across diverse populations, including non-obese individuals, without conclusive evidence linking supplementation to changes in BMI or age-specific advantages.

摘要

糖尿病的患病率不断攀升,预计到2045年将影响超过7亿人,这凸显了制定有效管理和预防策略的迫切需求,其中2型糖尿病(T2DM)在全球所有糖尿病病例中占比超过90%。目前的这项荟萃分析旨在严格评估补充维生素D在减轻T2DM发病方面的潜力,尽管其生物学合理性存在,但关于其降低该疾病新发病率的疗效证据尚无定论。截至2023年12月,在MEDLINE、EMBASE和Cochrane图书馆进行了全面的文献检索,采用聚焦于糖尿病和维生素D的策略,确定了探索补充维生素D对葡萄糖调节受损成年人T2DM发病影响的随机对照试验(RCT),通过Cochrane ROB2工具进行质量评估,并使用RevMan Web进行荟萃分析以评估效应大小和异质性。在一项对11项RCT(涉及5221名糖尿病前期患者)的荟萃分析中,补充维生素D与T2DM进展风险降低10%相关[风险比(RR),0.90;95%置信区间(CI),(0.81 - 0.99)],且血糖恢复正常的比例显著增加[RR,1.24;95% CI,(1.08 - 1.43)],未观察到显著的异质性或发表偏倚。这项对11项RCT的荟萃分析表明,糖尿病前期患者补充维生素D可降低T2DM风险并促进血糖恢复正常,在亚组分析或与基线维生素D水平、种族或体重指数(BMI)的相互作用方面无显著差异。尽管一些试验表明基线维生素D状态可能影响结果,但目前的综合分析发现,维生素D对包括非肥胖个体在内的不同人群均有益处,且没有确凿证据表明补充维生素D与BMI变化或特定年龄优势有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db5/11484325/c01c79965734/etm-28-06-12741-g00.jpg

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