Effects of vitamin D supplementation during weight loss on sex hormones in postmenopausal women
Effects of vitamin D supplementation during weight loss on sex hormones in postmenopausal women
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DOI：
10.1097/gme.0000000000000600
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发表时间：
2016-06-01
影响因子：
2.7
通讯作者：
McTiernan, Anne
中科院分区：
文献类型：
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作者：
Mason, Caitlin;Tapsoba, Jean De Dieu;McTiernan, Anne
目的：该研究的目的是比较维生素D3补充剂与安慰剂对完成12个月饮食+运动减肥计划的绝经后妇女血清性激素的影响。方法：218名血清25-羟基维生素D至少为10至小于32 ng/mL的超重或肥胖女性（50-75岁）（“不足”）被随机分配到体重减轻+ 2,000 IU/天口服维生素D-3，或体重减轻+每天安慰剂。在随机分组前和12个月时，通过放射免疫法测定血清性激素结合球蛋白、雌酮、总雌二醇、游离雌二醇和生物可利用雌二醇以及睾酮。平均变化进行了比较组间（意向治疗）使用广义estimating equations.Results：12个月的变化，性激素结合球蛋白，雌酮，总，游离，和生物可利用的雌二醇，睾酮组间没有差异（所有P > 0.05）。然而，血清25-羟基维生素D的增加与性激素结合球蛋白的增加（P趋势= 0.01）以及游离雌二醇和生物可利用雌二醇的减少（分别为P趋势= 0.04，P趋势= 0.03）相关。在事后分析中，我们比较了随机接受维生素D治疗但血清25-羟基维生素D仍然不足的妇女（n = 38）和补充维生素D的妇女（25-羟基维生素D ≥ 32 ng/mL; n = 53）。饱食的妇女表现出更大的减少生物可利用的雌二醇（-1.8 vs -0.7 pg/mL），游离睾酮（-0.8 vs -0.3 pg/mL）和生物可利用睾酮（-1.8 vs -0.6 ng/dL），以及性激素结合球蛋白的更大增加（10.6 vs 4.7 nmol/L）（均P < 0.05），即使在调整了12个月总体重减轻的差异后。结论：总体而言，两组间性激素的12个月变化没有差异。然而，维生素D补充与减肥期间性激素的减少有关，可能具有剂量依赖性效应。未来的研究应该测试更高的剂量，并在测量这种影响时针对循环中的25-羟基维生素D水平。
Objective: The aim of the study was to compare the effects of vitamin D3 supplementation versus placebo on serum sex hormones in postmenopausal women completing a 12-month diet + exercise weight loss program.Methods: Two hundred eighteen overweight or obese women (50-75 y) with serum 25-hydroxyvitamin D at least 10 to less than 32 ng/mL ("insufficient") were randomized to either weight loss + 2,000 IU/day oral vitamin D-3, or to weight loss + daily placebo. Serum sex hormone-binding globulin, estrone, total, free, and bioavailable estradiol, and testosterone were measured by radioimmunoassay before randomization and at 12 months. Mean changes were compared between groups (intent-to-treat) using generalized estimating equations.Results: The 12-month changes in sex hormone-binding globulin, estrone, total, free, and bioavailable estradiol, and testosterone did not differ between groups (all P > 0.05). However, a greater increase in serum 25-hydroxyvitamin D was associated with a greater increase in sex hormone-binding globulin (P-trend = 0.01), and larger decreases in free and bioavailable estradiol (P-trend = 0.04, P-trend = 0.03, respectively). In post-hoc analyses, we compared women randomized to vitamin D whose serum 25-hydroxyvitamin D remained insufficient (n = 38), to women who became replete (25-hydroxyvitamin D >= 32 ng/mL; n = 53). Replete women showed greater reductions in bioavailable estradiol (-1.8 vs -0.7 pg/mL), free testosterone (-0.8 vs -0.3 pg/mL), and bioavailable testosterone (-1.8 vs -0.6 ng/dL), and a greater increase in sex hormone-binding globulin (10.6 vs 4.7 nmol/L) (all P < 0.05), even after adjusting for differences in total 12-month weight loss.Conclusions: Overall, 12-month changes in sex hormone did not differ between groups. However, vitamin D repletion was associated with greater reductions in sex hormones during weight loss, with a possible dose-dependent effect. Future studies should test higher doses and target circulating 25-hydroxyvitamin D levels when measuring such effects.