Vitamin D and type 2 diabetes
Vitamin D and type 2 diabetes
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维生素 D 和 2 型糖尿病
DOI：
10.1016/j.jsbmb.2016.11.021
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发表时间：
2017-10-01
影响因子：
4.1
通讯作者：
Simsek, Suat
中科院分区：
文献类型：
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作者：
Lips, Paul;Eekhoff, Marelise;Simsek, Suat
在实验和流行病学研究中，维生素D缺乏与胰岛素释放减少、胰岛素抵抗和2型糖尿病有关。动物研究表明，1 α，25-二羟维生素D-3（1，25（OH）（2）D-3）刺激胰腺β细胞分泌胰岛素。维生素D缺乏和胰岛素抵抗之间的关系可能通过炎症发展，因为维生素D缺乏与炎症标志物增加有关。此外，维生素D相关基因的遗传多态性可能易患血糖控制受损和2型糖尿病。流行病学研究表明，低血清25-羟基维生素D-3（25（OH）D-3）浓度与代谢综合征和2型糖尿病风险增加之间存在关联。这可能部分由脂肪量增加解释。维生素D缺乏症和2型糖尿病之间可能存在因果关系，应通过随机临床试验证明，维生素D补充剂可以预防2型糖尿病或改善胰岛素释放和胰岛素敏感性。在葡萄糖耐量受损（“前驱糖尿病”）或2型糖尿病患者中，维生素D与安慰剂（有时与钙联合使用）效果的随机临床试验结果不一致。一些研究显示空腹血糖轻微下降或胰岛素抵抗改善，但通常仅在事后分析中。这些影响主要在基线时维生素D缺乏和糖耐量受损的患者中可见。随机临床试验的荟萃分析一般没有显示维生素D补充对血糖控制的显着影响。目前，正在进行几项大规模的随机临床试验，以1600-4000 IU/d的剂量补充维生素D，血糖控制或糖尿病发病率作为结局。维生素D缺乏症需要预防或治愈，但在这些试验结果公布之前，不能推荐高剂量维生素D补充剂用于预防或改善2型糖尿病。(C)2016爱思唯尔有限公司版权所有。
Vitamin D deficiency is associated with a decreased insulin release, insulin resistance and type 2 diabetes in experimental and epidemiological studies. Animal studies show that 1 alpha,25-dihydroxyvitamin D-3 (1,25 (OH)(2)D-3) stimulates the pancreatic beta-cell to secrete insulin. The relationship between vitamin D deficiency and insulin resistance could develop through inflammation, as vitamin D deficiency is associated with increased inflammatory markers. In addition, genetic polymorphisms of vitamin D related genes may predispose to impaired glycemic control and type 2 diabetes. Epidemiologic studies showed an association between low serum 25-hydroxyvitamin D-3 (25(OH)D-3) concentration and an increased risk for the metabolic syndrome and type 2 diabetes. This may be partly explained by an increased fat mass. A possible causal relationship between vitamin D deficiency and type 2 diabetes should be proven by randomized clinical trials showing that either type 2 diabetes can be prevented or insulin release and insulin sensitivity can be improved by vitamin D supplements. The results of randomized clinical trials on the effect of vitamin D versus placebo, sometimes combined with calcium, in patients with impaired glucose tolerance ("prediabetes") or type 2 diabetes are inconsistent. Some studies showed a slight decrease of fasting plasma glucose or improvement of insulin resistance, but often only in posthoc analyses. These effects are mainly visible in patients with vitamin D deficiency and impaired glucose tolerance at baseline. Meta-analyses of randomized clinical trials in general did not show significant effects of vitamin D supplementation on glycemic control. Currently, several large scale randomized clinical trials with vitamin D supplementation in doses of 1600-4000 IU/d are ongoing with glycemic control or incidence of diabetes mellitus as outcome. Vitamin D deficiency needs to be prevented or cured, but until the results of these trials are published; high-dose vitamin D supplementation cannot be recommended for prevention or amelioration of type 2 diabetes. (C) 2016 Elsevier Ltd. All rights reserved.