Vitamin D and diabetes.
Vitamin D and diabetes.
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DOI：
10.1016/j.jsbmb.2010.03.042
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发表时间：
2010-07
影响因子：
4.1
通讯作者：
Dawson-Hughes, Bess
中科院分区：
文献类型：
--
作者：
Pittas, Anastassios G.;Dawson-Hughes, Bess
根据动物和人类研究的证据，维生素D已成为1型和2型糖尿病（1型糖尿病和2型糖尿病）的潜在风险调节剂。维生素D被认为对与两种类型的糖尿病的病理生理学相关的各种机制具有直接（通过激活维生素D受体）和间接（通过调节钙稳态）作用，包括胰腺β细胞功能障碍、胰岛素作用受损和全身性炎症。观察性病例对照研究表明，在怀孕或幼儿期补充维生素D与降低1型糖尿病发病风险有关。目前还没有关于维生素D（麦角钙化醇或胆钙化醇）对1型糖尿病影响的试验。在纵向观察性研究中已经报道了维生素D不足和2型糖尿病之间的关联，但这种关联并不一致。来自小型动力不足试验的结果和针对骨骼特异性结局设计的大型试验数据的事后分析显示，维生素D补充剂对健康成人的糖尿病没有影响，但维生素D可能会延缓葡萄糖耐受不良成人的糖尿病进展。由于维生素D是一般健康状况的一个很好的标志物，一些观察性研究报告的阳性结果可能反映了未测量和未解释的混杂因素。因此，维生素D可能改变糖尿病风险的假设需要在专门为此目的设计的试验中得到证实。
On the basis of evidence from animal and human studies, vitamin D has emerged as a potential risk modifier for type 1 and type 2 diabetes (type 1 diabetes and type 2 diabetes). Vitamin D is thought to have both direct (through activation of the vitamin D receptor) and indirect (via regulation of calcium homeostasis) effects on various mechanisms related to the pathophysiology of both types of diabetes, including pancreatic beta cell dysfunction, impaired insulin action and systemic inflammation. Observational case-control studies have shown that vitamin D supplementation in pregnancy or early childhood is associated with reduced risk of incident type 1 diabetes. There are no trials on the effect of vitamin D (ergocalciferol or cholecalciferol) on type 1 diabetes. An association between vitamin D insufficiency and incident type 2 diabetes has been reported in longitudinal observational studies, but the association is not consistent. Results from small underpowered trials and post-hoc analyses of data from larger trials designed for bone-specific outcomes show no effect of vitamin D supplementation on glycemia in healthy adults but vitamin D may retard the progression to diabetes in adults with glucose intolerance. Because vitamin D is an excellent marker of general health status, the positive results reported in some observational studies might reflect unmeasured and unaccounted confounding. Therefore, the hypothesis that vitamin D may modify diabetes risk needs to be confirmed in trials specifically designed for that purpose.
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