Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial
Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial
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DOI：
10.3945/ajcn.112.050013
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发表时间：
2013-04-01
影响因子：
7.1
通讯作者：
Peterson, Catherine A.
中科院分区：
文献类型：
--
作者：
Belenchia, Anthony M.;Tosh, Aneesh K.;Peterson, Catherine A.
背景：肥胖的青少年更容易缺乏维生素D，因为维生素D被认为被多余的脂肪组织所吸收。维生素D缺乏与代谢综合征、2型糖尿病或两者在成人和青少年中的较高患病率相关。目的：目的是确定4000 IU维生素D-3/d对肥胖青少年的疗效和安全性，以及随后增加的25-羟基维生素D [25（OH）D]循环浓度是否设计：肥胖青少年患者[n = 35;平均值+/- SD年龄：14.1 ± 2.8岁; BMI：（kg/m2）：39.8 +/- 6.1; 25（OH）D：19.6 +/- 7.1 ng/mL]从密苏里州大学青少年糖尿病和肥胖症诊所招募，并随机分配接受维生素D-3（4000 IU/d）或安慰剂作为标准治疗的一部分。在基线和2次随访访视（3和6 mo）时测量人体测量、炎症标志物（IL-6、TNF-α、C-反应蛋白）、脂肪因子（瘦素、脂联素）、空腹血糖、空腹胰岛素和HOMA-IR值。补充维生素D3的参与者血清25（OH）D浓度增加（19.5 ng/mL，安慰剂组为2.8 ng/mL; P < 0.001），空腹胰岛素（-6.5，安慰剂组为+1.2 mu U/mL; P = 0.026），HOMA-IR（-1.363对比安慰剂+0.27; P = 0.033）和瘦素与脂联素比率（-1.41对比安慰剂+0.10; P = 0.045）。炎症标志物保持不变。结论：通过膳食补充剂纠正维生素D缺乏状态可能是一种有效的补充肥胖及其相关的胰岛素抵抗的标准治疗。本试验在clinicaltrials.gov上注册为NCT 00994396。美国临床营养杂志2013;97：774-81。
Background: Obese adolescents are at a greater risk of vitamin D deficiency because vitamin D is thought to be sequestered by excess adipose tissue. Poor vitamin D status has been associated with a higher prevalence of the metabolic syndrome, type 2 diabetes, or both in adults and adolescents.Objective: The objective was to determine in obese adolescents the efficacy and safety of 4000 IU vitamin D-3/d and whether subsequent increased circulating concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with improved markers of insulin sensitivity and resistance and reduced inflammation.Design: Obese adolescent patients [n = 35; mean +/- SD age: 14.1 +/- 2.8 y; BMI (in kg/m(2)): 39.8 +/- 6.1; 25(OH)D: 19.6 +/- 7.1 ng/mL] were recruited from the University of Missouri Adolescent Diabetes and Obesity Clinic and were randomly assigned to receive either vitamin D-3 (4000 IU/d) or placebo as part of their standard care. Anthropometric measurements, inflammatory markers (IL-6, TNF-alpha, C-reactive protein), adipokines (leptin, adiponectin), fasting glucose, fasting insulin, and HOMA-IR values were measured at baseline and at 2 follow-up visits (3 and 6 mo).Results: After 6 mo, there were no significant differences in BMI, serum inflammatory markers, or plasma glucose concentrations between groups. Participants supplemented with vitamin D3 had increases in serum 25(OH)D concentrations (19.5 compared with 2.8 ng/mL for placebo; P < 0.001), fasting insulin (-6.5 compared with +1.2 mu U/mL for placebo; P = 0.026), HOMA-IR (-1.363 compared with +0.27 for placebo; P = 0.033), and leptin-to-adiponectin ratio (-1.41 compared with +0.10 for placebo; P = 0.045). Inflammatory markers remained unchanged.Conclusion: The correction of poor vitamin D status through dietary supplementation may be an effective addition to the standard treatment of obesity and its associated insulin resistance. This trial was registered at clinicaltrials.gov as NCT00994396. Am J Clin Nutr 2013;97:774-81.