补充维生素D对2型糖尿病患者空腹血糖、胰岛素敏感性及炎症的影响:一项系统评价与Meta分析

The Impact of Vitamin D Supplementation on Fasting Plasma Glucose, Insulin Sensitivity, and Inflammation in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

作者信息

Probosari Enny, Subagio Hertanto W, Rachmawati Banundari, Muis Siti F, Tjandra Kevin C, Adiningsih Dwi, Winarni Tri I

机构信息

Doctoral Program of Medical and Health Sciences, Faculty of Medicine, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia.

Clinical Nutrition Department, Faculty of Medicine, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia.

出版信息

Nutrients. 2025 Jul 30;17(15):2489. doi: 10.3390/nu17152489.

Abstract

: Vitamin D supplementation has shown promise in managing type 2 diabetes mellitus (T2DM), while the simultaneous impact on glycemic control and inflammation in T2DM remains poorly understood. This study aimed to investigate the potential role of vitamin D supplementation in managing T2DM using fasting plasma glucose (FPG), insulin levels, HOMA-IR, HOMA-B, HbA1c, and Hs-CRP as the biomarkers. : Original articles from Scopus, Pubmed, Cochrane Library, Epistemonikos, and ScienceDirect published between 2014 and 2024 were the sources. Inclusion criteria included studies conducted as clinical trials or randomized controlled trials involving adult patients diagnosed with T2DM undergoing treatment with vitamin D. The risk of bias was evaluated using the ROB-2 tool and meta-analysis was conducted to quantitatively synthesize the results across the studies using pooled effect sizes and confidence intervals. : Nine studies were included in the meta-analysis. Significant differences were found at 12-week follow-up in insulin level (MD(-3.59) [95% CI: -6.93, -0.25]), HOMA-B (MD(-50.35) [95% CI: -92.29, -8.41]), hs-CRP (-2.51 [95% CI: -3.45, -1.57]), and HbA1c level (MD(-0.30) [95% CI: -0.54, -0.06]) and at 24-week follow-up in HOMA-IR (MD(-0.38) [CI: -0.53, -0.24]). The quality of the included studies was generally moderate, with three showing a potential risk of bias. : The observed trends in FPG, insulin levels, HOMA-IR, HOMA-B, HbA1c, and hs-CRP indicate that vitamin D may influence glycemic control, insulin sensitivity, and inflammation, but these effects are often modest and may diminish over time. Future studies should explore longer duration randomized trials with standardized dosing and baseline vitamin D status stratification.

摘要

维生素D补充剂在2型糖尿病(T2DM)的管理中显示出前景,然而其对T2DM血糖控制和炎症的同时影响仍知之甚少。本研究旨在以空腹血糖(FPG)、胰岛素水平、HOMA-IR、HOMA-B、糖化血红蛋白(HbA1c)和超敏C反应蛋白(Hs-CRP)作为生物标志物,探讨维生素D补充剂在T2DM管理中的潜在作用。

来自Scopus、Pubmed、Cochrane图书馆、Epistemonikos和ScienceDirect在2014年至2024年间发表的原始文章为资料来源。纳入标准包括作为临床试验或随机对照试验进行的研究,涉及被诊断为T2DM且正在接受维生素D治疗的成年患者。使用ROB-2工具评估偏倚风险,并进行荟萃分析以使用合并效应量和置信区间对各项研究结果进行定量综合。

九项研究被纳入荟萃分析。在12周随访时,胰岛素水平(MD(-3.59)[95%CI:-6.93,-0.25])、HOMA-B(MD(-50.35)[95%CI:-92.29,-8.41])、hs-CRP(-2.51[95%CI:-3.45,-1.57])和HbA1c水平(MD(-0.30)[95%CI:-0.54,-0.06])存在显著差异,在24周随访时HOMA-IR(MD(-0.38)[CI:-0.53,-0.24])存在显著差异。纳入研究的质量总体中等,三项研究显示存在潜在偏倚风险。

FPG、胰岛素水平、HOMA-IR、HOMA-B、HbA1c和hs-CRP的观察趋势表明,维生素D可能影响血糖控制、胰岛素敏感性和炎症,但这些影响通常较小,且可能随时间减弱。未来的研究应探索持续时间更长的随机试验,采用标准化给药和基线维生素D状态分层。

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