Paricalcitol does not improve glucose metabolism in patients with stage 3-4 chronic kidney disease.
Paricalcitol does not improve glucose metabolism in patients with stage 3-4 chronic kidney disease.
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DOI：
10.1038/ki.2012.311
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发表时间：
2013-02
影响因子：
19.6
通讯作者：
中科院分区：
文献类型：
--
作者：
慢性肾病患者通常具有胰岛素抵抗和葡萄糖不耐受;这些异常会促进心血管疾病。给予1，25-二羟维生素D（骨化三醇）可改善终末期肾病患者的葡萄糖代谢。我们进行了一项随机、安慰剂对照的临床试验，以测试帕立骨化醇（一种1，25-二羟基维生素D类似物）是否会改变慢性肾脏疾病早期阶段的葡萄糖耐量。在交叉设计中，22例估计肾小球滤过率为3-4期慢性肾脏疾病且空腹血糖100-125 mg/dL的非糖尿病患者接受每日口服帕立骨化醇治疗8周，并接受匹配安慰剂治疗8周，中间间隔8周洗脱期。干预的顺序是随机的，对参与者和研究者都是盲的。帕立骨化醇显著降低甲状旁腺激素、1，25-二羟基维生素D和25-羟基维生素D的血清浓度，同时显著增加成纤维细胞生长因子-23和24，25-二羟基维生素D的血清浓度。然而，帕立骨化醇对葡萄糖耐量（主要结局指标）、胰岛素敏感性、β细胞胰岛素反应、血浆游离脂肪酸抑制或尿F2-异前列烷排泄无显著影响。因此，尽管帕立骨化醇对维生素D代谢有显著影响，但在3-4期慢性肾病非糖尿病患者中，帕立骨化醇并未改善葡萄糖代谢。
Patients with chronic kidney disease are often insulin resistant and glucose intolerant; abnormalities that promote cardiovascular disease. Administration of 1,25-dihydroxyvitamin D (calcitriol) has improved glucose metabolism in patients with end stage renal disease. We conducted a randomized, placebo-controlled clinical trial to test whether paricalcitol, a 1,25-dihydroxyvitamin D analogue, changes glucose tolerance in earlier stages of chronic kidney disease. In a cross-over design, 22 non-diabetic patients with estimated glomerular filtration rates of stage 3-4 chronic kidney disease and fasting plasma glucose 100-125 mg/dL were given daily oral paricalcitol for 8 weeks and matching placebo for 8 weeks, separated by an 8-week washout period. The order of interventions was random and blinded to both participants and investigators. Paricalcitol significantly reduced serum concentrations of parathyroid hormone, 1,25-dihydroxyvitamin D, and 25-hydroxyvitamin D while significantly increasing serum concentrations of fibroblast growth factor-23 and 24,25-dihydroxyvitamin D. Paricalcitol, however, had no significant effect on glucose tolerance (the primary outcome measure), insulin sensitivity, beta-cell insulin response, plasma free fatty acid suppression, or urinary F2-isoprostane excretion. Thus, despite substantial effects on vitamin D metabolism, paricalcitol did not improve glucose metabolism in non-diabetic patients with stage 3-4 chronic kidney disease.
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影响因子：
19.6
作者：
Li, Yan Chun
通讯作者：
Li, Yan Chun
DOI：
10.1152/ajpgi.00243.2005
发表时间：
2005-12-01
影响因子：
4.5
作者：
Kolek, OI;Hines, ER;Ghishan, FK
通讯作者：
Ghishan, FK
影响因子：
6.1
作者：
Hansen, Ditte;Rasmussen, Knud;Brandi, Lisbet
通讯作者：
Brandi, Lisbet
影响因子：
19.6
作者：
Dusso, Adriana S.;Tokumoto, Masanori
通讯作者：
Tokumoto, Masanori
影响因子：
13.2
作者：
Coyne, D;Acharya, M;Sprague, SM
通讯作者：
Sprague, SM