Gao Yue-Qiao, Gao Ying-Hui, Xing Jun-Hui
Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
World J Diabetes. 2025 Aug 15;16(8):108166. doi: 10.4239/wjd.v16.i8.108166.
Diabetic foot ulcers (DFUs) represent a common and serious complication of diabetes, characterized by impaired wound healing and an increased risk of infection. These infections severely impact patient health, necessitating extensive medical intervention, and increasing the risk of amputation. Vitamin D (VD) plays a critical role in immune regulation and tissue repair.
To investigate the effects of VD supplementation on infection rates, wound healing, and immune function in patients with DFUs.
A randomized controlled trial was conducted involving 120 patients with DFUs. Participants were randomly assigned to either a control group ( = 60), which received standard care without VD supplementation, or an intervention group ( = 60), which received 2000 IU of oral VD3 (cholecalciferol) daily for 12 weeks. The primary outcomes included the incidence and severity of infections, whereas the secondary outcomes included wound healing rate, serum 25-hydroxyvitamin D level, levels of immune markers (cathelicidin, interleukin-6 and tumor necrosis factor-α), and adverse events, such as hypercalcemia.
The incidence of infection was significantly lower in the VD supplementation group (25%) compared with the control group (45%) ( = 0.01). Severe infections requiring systemic antibiotics or hospitalization were also less frequent in the VD supplementation group. Wound healing was notably enhanced in the VD supplementation group, with a 60% reduction in ulcer size compared with a 35% reduction in the control group ( < 0.01). Serum 25(OH)D level significantly increased in the VD supplementation group (from 16.5 ng/mL to 35.2 ng/mL), confirming the efficacy of VD supplementation. Immune function improved, as demonstrated by a 30% rise in cathelicidin level and a 20% decline in levels of pro-inflammatory cytokines. No adverse effects, including hypercalcemia, were reported.
The VD supplementation effectively reduced infection rate, promoted wound healing, and strengthened immune responses in patients with DFUs. These findings support the incorporation of VD as a safe and effective adjunctive therapy in the clinical management of DFUs.
糖尿病足溃疡（DFUs）是糖尿病常见且严重的并发症，其特点是伤口愈合受损且感染风险增加。这些感染严重影响患者健康，需要广泛的医疗干预，并增加截肢风险。维生素D（VD）在免疫调节和组织修复中起关键作用。
研究补充VD对DFUs患者感染率、伤口愈合及免疫功能的影响。
进行了一项随机对照试验，纳入120例DFUs患者。参与者被随机分为对照组（n = 60），接受不补充VD的标准护理，或干预组（n = 60），每天口服2000 IU的VD3（胆钙化醇），持续12周。主要结局包括感染的发生率和严重程度，次要结局包括伤口愈合率、血清25-羟维生素D水平、免疫标志物（杀菌肽、白细胞介素-6和肿瘤坏死因子-α）水平以及不良事件，如高钙血症。
补充VD组的感染发生率（25%）显著低于对照组（45%）（P = 0.01）。补充VD组中需要全身使用抗生素或住院治疗的严重感染也较少见。补充VD组的伤口愈合明显增强，溃疡大小减少60%，而对照组减少35%（P < 0.01）。补充VD组的血清25(OH)D水平显著升高（从16.5 ng/mL升至35.2 ng/mL），证实了补充VD的有效性。免疫功能得到改善，杀菌肽水平升高30%，促炎细胞因子水平下降20%。未报告包括高钙血症在内的不良反应。
补充VD可有效降低DFUs患者的感染率，促进伤口愈合，并增强免疫反应。这些发现支持将VD作为DFUs临床管理中安全有效的辅助治疗方法。
