Effects of Genetic and Nongenetic Factors on Total and Bioavailable 25(OH)D Responses to Vitamin D Supplementation
Effects of Genetic and Nongenetic Factors on Total and Bioavailable 25(OH)D Responses to Vitamin D Supplementation
复制标题
遗传和非遗传因素对补充维生素 D 的总 25(OH)D 和生物利用度 25(OH)D 反应的影响
DOI：
10.1210/jc.2016-2930
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发表时间：
2017-01-01
影响因子：
5.8
通讯作者：
Lin, Xu
中科院分区：
文献类型：
--
作者：
Yao, Pang;Sun, Liang;Lin, Xu
背景：关于遗传和非遗传因素如何改变非白人人群补充维生素D的反应，我们知之甚少。目的：探讨维生素D3补充后25-羟基维生素ind [25(OH)D]和生物可利用性25(OH)D [25(OH)D- bio]的影响因素。设计、环境、参与者和干预：在这项为期20周的随机、双盲、安慰剂对照试验中，448名维生素D缺乏症患者接受2000 IU/ D维生素D-3或安慰剂治疗。主要观察指标：测定血清25(OH)D、维生素D结合蛋白（VDBP）、甲状旁腺激素（PTH）、钙，并根据VDBP水平计算25(OH)D- bio。对维生素D代谢基因的6个常见多态性进行了基因分型。结果：25(OH)D的臂间净变化为+ 30.6 +/- 1.7 nmol/L, 25(OH)D - bio的臂间净变化为+ 2.7 +/- 0.2 nmol/L， PTH的臂间净变化为-5.2 +/- 1.2 pg/mL，对应于维生素D缺乏症在第20周的70%[95%置信区间（CI）， 62.8%至77.2%]净逆转率（P < 0.001）。只有25(OH) DBio变化与钙变化呈正相关（P < 0.001）。遗传因素（GC-rs4588/GC-rs7041、VDR-rs2228570和CYP2R1-rs10741657； P # 0.04）对25(OH)D或25(OH)D- bio反应的影响强于非遗传因素，包括基线值、体重指数和性别。PTH-25(OH) D仅在25(OH)D为50.8 (95% CI, 43.6 ~ 59.0) nmol/L时呈负相关。结论：补充2000 IU/d维生素D3提高了25(OH) d和25(OH) d - bio，但无法纠正25%的中国参与者的缺乏症，这可能部分归因于转基因的影响。需要更多的研究来阐明亚洲人适当的维生素推荐和25(OH)D-Bio的潜在临床意义。
Context: Little is known about how genetic and nongenetic factors modify responses of vitamin D supplementation in nonwhite populations.Objective: To investigate factorsmodifying 25-hydroxyvitaminD[25(OH) D] and bioavailable 25(OH)D [25(OH)D-Bio] responses after vitamin D3 supplementation.Design, Setting, Participants, and Intervention: In this 20-week, randomized, double-blinded, placebo-controlled trial, 448 Chinese with vitamin D deficiency received 2000 IU/d vitamin D-3 or placebo.Main Outcome Measures: Serum 25(OH) D, vitamin D-binding protein (VDBP), parathyroid hormone (PTH) and calcium were measured, and 25(OH)D-Bio was calculated based on VDBP levels. Six common polymorphisms in vitamin D metabolism genes were genotyped.Results: Between-armnet changeswere + 30.6 +/- 1.7 nmol/L for 25(OH)D, + 2.7 +/- 0.2 nmol/L for 25(OH) D-Bio, and -5.2 +/- 1.2 pg/mL for PTH, corresponding to 70% [95% confidence interval (CI), 62.8% to 77.2%] net reversion rate for vitamin D deficiency atweek 20 (P < 0.001). Only 25(OH) DBio changewas positively associated with calcium change (P < 0.001). Genetic factors (GC-rs4588/GC-rs7041, VDR-rs2228570, and CYP2R1-rs10741657; P # 0.04) showed stronger influences on 25(OH)D or 25(OH)D-Bio responses than nongenetic factors, including baseline value, body mass index, and sex. An inverse association of PTH-25(OH) Dwas demonstrated only at 25(OH)D of, 50.8 (95% CI, 43.6 to 59.0) nmol/L.Conclusions: Supplemented 2000 IU/d vitamin D3 raised 25(OH)D and 25(OH)D-Bio but was unable to correct deficiency in 25% of Chinese participants, which might be partially attributed to the effect of geneticmodification. More studies are needed to elucidate appropriate vitaminDrecommendations for Asians and the potential clinical implications of 25(OH)D-Bio.