Vitamin D & its analogues in type 2 diabetic nephropathy: a systematic review.
Vitamin D & its analogues in type 2 diabetic nephropathy: a systematic review.
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DOI：
10.1186/s40200-015-0186-6
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发表时间：
2015
影响因子：
2.8
通讯作者：
Inamdar AS
中科院分区：
文献类型：
--
作者：
Chokhandre MK;Mahmoud MI;Hakami T;Jafer M;Inamdar AS
肾病是糖尿病的主要并发症之一，常导致慢性肾病（CKD）。炎症和氧化应激与糖尿病肾病（DN）的发病机制有关，并被发现受到核受体如维生素D受体（VDR）的调节。维生素D及其类似物已有效用于CKD患者。本文综述了维生素D在糖尿病肾病中的作用。在电子数据库（MEDLINE、EMBASE和科克伦图书馆）中检索评估维生素D或其类似物对2型糖尿病患者肾功能作用的研究。纳入了评价肾功能（尿白蛋白/蛋白肌酐比值、白蛋白尿和eGFR）的研究，并进行了偏倚质量和风险评估。此外，还评价了对25（OH）维生素D、钙和HbA 1c的影响。平均值或其变化沿着%及其标准差（SD）用于报告我们的结果。使用RevMan（V5.2）进行数据分析。本综述中纳入的6项研究评价了胆钙化醇、骨化三醇和帕立骨化醇在DN患者中的作用。研究设计不同（三项随机试验，一项非随机试验和两项非对照试验），质量和偏倚风险程度不同。在两项随机研究中，维生素D类似物显示肾功能显著改善。没有研究报告高钙血症的显著发生率。维生素D类似物可显著改善DN患者的肾功能。需要更长时间的随机对照试验，比较维生素D及其类似物的疗效。本文的在线版本（doi：10.1186/s40200-015-0186-6）包含补充材料，可供授权用户使用。
Nephropathy is one of the major complications of diabetes often leading to chronic kidney disease (CKD). Inflammation and oxidative stress are associated with pathogenesis of diabetic nephropathy (DN) and found to be regulated by nuclear receptors such as vitamin D receptors (VDR). Vitamin D and its analogues have been effectively used in patients with CKD. The review attempts to summarize the available evidence on the role of vitamin D in DN. Electronic databases (MEDLINE, EMBASE, and Cochrane Library) were searched for studies assessing the role of vitamin D or its analogues on kidney function in type 2 diabetic patients. Studies evaluating kidney functions (urinary albumin/protein creatinine ratio, albuminuria and eGFR) were included and quality and risk of bias assessment performed. Additionally effect on 25 (OH) vitamin D, calcium and HbA1c were evaluated. The mean or its % change along with their standard deviation (SD) was used for reporting our results. RevMan (V5.2) was used for data analysis. Six studies included in this review evaluated the role of cholecalciferol, calcitriol and paricalcitol in patients with DN. Study designs differed (three randomized, one non-randomized and two uncontrolled trials) with varying degree of quality and risk of biases. Vitamin D analogues showed significant improvement in kidney function in two randomized studies. None of the studies reported significant incidences of hypercalcemia. Vitamin D analogues show significant improvement of kidney function in DN. Randomized controlled trials with longer duration, comparing the efficacy of vitamin D and its analogues are needed. The online version of this article (doi:10.1186/s40200-015-0186-6) contains supplementary material, which is available to authorized users.