Kretschmer Philip M, Balk Ethan M, Pittas Anastassios G
Division of General Internal Medicine, Tufts Medical Center, Boston, MA 02111, USA.
Center for Evidence Synthesis in Health Brown University, Providence, RI 02912, USA.
J Endocr Soc. 2025 Mar 3;9(5):bvaf042. doi: 10.1210/jendso/bvaf042. eCollection 2025 May.
Meta-analyses of clinical trials have shown that vitamin D lowers the risk of progression from prediabetes to diabetes. Less is known about whether vitamin D promotes regression to normal glucose regulation (NGR). We conducted a systematic review and meta-analysis of clinical trials with vitamin D in adults with prediabetes that have reported on the outcome of regression to NGR. We searched Medline (through PubMed), Embase, and the trial registry ClinicalTrials.gov from inception to July 3, 2024, for randomized, controlled trials of at least 6 months' duration that reported on the effects of oral vitamin D supplementation on NGR in adults with prediabetes. The search identified 10 eligible trials, involving 4478 participants. The baseline characteristics of the study cohorts were: mean age range 20 to 74 years, mean body mass index range 24 to 38, mean blood 25-hydroxyvitamin D range 12 to 28 ng/mL. The median study duration range was 0.5 to 5 years. Across trials, 416 of 2253 (18.5%) participants randomly assigned to vitamin D reached NGR vs 312 of 2225 (14.0%) participants randomly assigned to placebo. In all trials, the relative risk of regression to NGR favored the vitamin D group, ranging from 1.09 to 12.6. After combining data, the summary relative risk of regression to NGR for vitamin D vs placebo was 1.27 (95% CI, 1.12-1.45), with no heterogeneity ( = 1%). Sensitivity analyses did not change the result. Participant-level variables were not available, limiting meaningful subgroup analyses. In conclusion, vitamin D increases the likelihood of regression to normoglycemia in adults with prediabetes.
临床试验的荟萃分析表明,维生素D可降低从糖尿病前期进展为糖尿病的风险。关于维生素D是否能促进血糖回归正常调节(NGR),人们了解得较少。我们对糖尿病前期成人使用维生素D的临床试验进行了系统评价和荟萃分析,这些试验报告了血糖回归NGR的结果。我们检索了Medline(通过PubMed)、Embase和试验注册库ClinicalTrials.gov,检索时间从创建至2024年7月3日,查找至少为期6个月的随机对照试验,这些试验报告了口服维生素D补充剂对糖尿病前期成人NGR的影响。检索共识别出10项符合条件的试验,涉及4478名参与者。研究队列的基线特征为:平均年龄范围20至74岁,平均体重指数范围24至38,平均血液25-羟基维生素D范围12至28 ng/mL。研究持续时间的中位数范围为0.5至5年。在所有试验中,随机分配到维生素D组的2253名参与者中有416名(18.5%)实现了NGR,而随机分配到安慰剂组的2225名参与者中有312名(14.0%)实现了NGR。在所有试验中,血糖回归NGR的相对风险有利于维生素D组,范围为1.09至12.6。合并数据后,维生素D组与安慰剂组血糖回归NGR的汇总相对风险为1.27(95%CI,1.12 - 1.45),无异质性(I² = 1%)。敏感性分析未改变结果。由于无法获取参与者水平的变量,限制了有意义的亚组分析。总之,维生素D可增加糖尿病前期成人血糖回归正常的可能性。