Vitamin D Supplementation Does Not Impact Insulin Resistance in Black and White Children
Vitamin D Supplementation Does Not Impact Insulin Resistance in Black and White Children
复制标题
补充维生素D不影响黑人和白色儿童的胰岛素抵抗
DOI：
10.1210/jc.2015-3687
复制
发表时间：
2016-04-01
影响因子：
5.8
通讯作者：
Lewis, Richard D.
中科院分区：
文献类型：
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作者：
Ferira, Ashley J.;Laing, Emma M.;Lewis, Richard D.
背景：维生素D补充剂与糖尿病相关结果的试验几乎只在成人中进行，并提供了模棱两可的结果。目的：本研究的目的是确定9-13岁的白人和黑人儿童服用维生素D补充剂对空腹血糖、胰岛素和胰岛素抵抗的替代测量的剂量-反应，这些儿童参加了乔治亚、普渡和印第安纳大学(或GAPI)的试验：一项为期12周的多点、随机、三组掩蔽、剂量-反应、安慰剂对照的维生素D试验。设计：青春期早期的黑人和白人儿童(N=323，50%男性，51%的黑人)被同等随机地接受维生素D3(0、400、1000、2000或4000国际单位/天)，为期12周。在基线、6周和12周测定空腹血清25-羟基维生素D(25(OH)D)、血糖和胰岛素。胰岛素抵抗的稳态模型评估作为胰岛素抵抗的替代指标。结果：在调整了种族、性别、年龄、青春期成熟、脂肪质量和体重指数后，基线血清25(OH)D与胰岛素(r=-0.140，P=0.017)和胰岛素抵抗的稳态模型评估(r=-0.146，P=0.012)呈负相关。血糖、胰岛素和胰岛素抵抗在12周内增加(F>；5.79，P<；0.003)，尽管血清25(OH)D水平随着维生素D剂量的增加而增加。结论：尽管血清25(OH)D与胰岛素抵抗指标之间存在显著的基线负相关，但补充维生素D对12周以上的健康儿童的空腹血糖、胰岛素或胰岛素抵抗替代指标没有影响。
Context: Vitamin D supplementation trials with diabetes-related outcomes have been conducted almost exclusively in adults and provide equivocal findings.Objective: The objective of this study was to determine the dose-response of vitamin D supplementation on fasting glucose, insulin, and a surrogate measure of insulin resistance in white and black children aged 9-13 years, who participated in the Georgia, Purdue, and Indiana University (or GAPI) trial: a 12-week multisite, randomized, triple-masked, dose-response, placebo-controlled vitamin D trial.Design: Black and white children in the early stages of puberty (N = 323, 50% male, 51% black) were equally randomized to receive vitamin D3 (0, 400, 1000, 2000, or 4000 IU/day) for 12 weeks. Fasting serum 25-hydroxyvitamin D (25(OH)D), glucose and insulin were assessed at baseline and weeks 6 and 12. Homeostasis model assessment of insulin resistance was used as a surrogate measure of insulin resistance. Statistical analyses were conducted as intent-to-treat using a mixed effects model.Results: Baseline serum 25(OH)D was inversely associated with insulin (r = -0.140, P = 0.017) and homeostasis model assessment of insulin resistance (r = -0.146, P = 0.012) after adjusting for race, sex, age, pubertal maturation, fat mass, and body mass index. Glucose, insulin, and insulin resistance increased (F > 5.79, P < .003) over the 12 weeks, despite vitamin D dose-dependent increases in serum 25(OH)D.Conclusions: Despite significant baseline inverse relationships between serum 25(OH)D and measures of insulin resistance, vitamin D supplementation had no impact on fasting glucose, insulin, or a surrogate measure of insulin resistance over 12 weeks in apparently healthy children.