A randomised controlled trial evaluating the impact of targeted vitamin D supplementation on endothelial function in type 2 diabetes mellitus: The DIMENSION trial.
A randomised controlled trial evaluating the impact of targeted vitamin D supplementation on endothelial function in type 2 diabetes mellitus: The DIMENSION trial.
复制标题
DOI：
10.1177/1479164115621667
复制
发表时间：
2016-05
影响因子：
2.4
通讯作者：
Leow MK
中科院分区：
文献类型：
--
作者：
Dalan R;Liew H;Assam PN;Chan ES;Siddiqui FJ;Tan AW;Chew DE;Boehm BO;Leow MK
我们试图确定补充维生素 D（将 25(OH)D 浓度控制在 30–40 ng/mL）是否可以改善新加坡多种族 2 型糖尿病人群的内皮功能。我们将 64 名患有维生素 D 缺乏症的 2 型糖尿病患者随机分配至胆钙化醇 4000 国际单位/匹配安慰剂 [基线 25(OH)D < 20 ng/mL] 或胆钙化醇 2000 国际单位/匹配安慰剂 [基线 25(OH)D：20–30 ng/mL]，每天服用16 周，在8 周时下调滴定，如果 25(OH)D > 30 ng/mL。通过外周张力测定（反应性充血指数 - 内皮外周动脉张力测定）和血管生物标志物（E-选择素、冯维勒布兰德因子和高敏 C 反应蛋白）评估内皮功能。我们使用学生 t 检验或 Kruskal-Wallis 检验比较了两组中基线参数的变化。使用对数正态多元回归分析来调整相关基线变量。维生素 D 组的中位反应性充血指数从 0.65（四分位距：0.42）增加到 0.73（四分位距：0.36），而安慰剂组则从 0.73（四分位距：0.65）下降到 0.65（四分位距：0.38）（p = 0.02）。调整基线变量后，反应性充血指数（p = 0.07）和其他血管生物标志物（p > 0.05）的变化不具有统计学意义。在 2 型糖尿病队列中，有针对性地补充维生素 D 16 周后，内皮功能出现了小幅但不显着的改善。
We sought to determine if vitamin D supplementation, to target 25(OH)D concentrations of 30–40 ng/mL, improves endothelial function in Singapore’s multi-ethnic type 2 diabetes mellitus population. We randomised 64 type 2 diabetes mellitus patients with hypovitaminosis D to cholecalciferol 4000 International Unit/matching placebo [baseline 25(OH)D < 20 ng/mL] or cholecalciferol 2000 International Unit/matching placebo [baseline 25(OH)D: 20–30 ng/mL] daily for 16 weeks with a down titration at 8 weeks if 25(OH)D > 30 ng/mL. Endothelial function was assessed by peripheral tonometry (reactive hyperaemia index–endothelial peripheral arterial tonometry) and vascular biomarkers: E-selectin, von-Willebrand factor and high-sensitivity C-reactive protein. We compared the change from baseline parameters in the two groups using Student’s t-test or Kruskal–Wallis test. A log-normal multivariate regression analysis was used to adjust for relevant baseline variables. The median reactive hyperaemia index in the vitamin D group increased from 0.65 (interquartile range: 0.42) to 0.73 (interquartile range: 0.36), whereas it decreased from 0.73 (interquartile range: 0.65) to 0.65 (interquartile range: 0.38) (p = 0.02) in the placebo group. After adjustment for baseline variables, the change was not statistically significant for reactive hyperaemia index (p = 0.07) and for other vascular biomarkers (p > 0.05). Targeted vitamin D supplementation for 16 weeks resulted in a small but non-significant improvement in endothelial function in a type 2 diabetes mellitus cohort.