Vitamin D and ω-3 Supplementations in Mediterranean Diet During the 1st Year of Overt Type 1 Diabetes: A Cohort Study
Vitamin D and ω-3 Supplementations in Mediterranean Diet During the 1st Year of Overt Type 1 Diabetes: A Cohort Study
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DOI：
10.3390/nu11092158
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发表时间：
2019-09-01
期刊：
影响因子：
5.9
通讯作者：
Ricordi, Camillo
中科院分区：
文献类型：
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作者：
Cadario, Francesco;Pozzi, Erica;Ricordi, Camillo
维生素D和ω-3脂肪酸（ω-3）共同补充可能通过减弱自身免疫和对抗炎症来改善1型糖尿病（T1 D）。这项队列研究是随机对照试验（RCT）的初步研究，目的是在一系列T1 D儿童中评估ω-3联合补充剂是否能保留残余内源性胰岛素分泌（REIS），这些儿童采用地中海饮食，从T1 D发作开始每天摄入1000 U胆钙化醇。因此，2017年的22例“新发”队列接受了omega-3（二十碳五烯酸（EPA）加二十二碳六烯酸（DHA），60 mg/kg/天），并与37例未补充omega-3的“既往发病”进行了回顾性比较。在招募时（T0）和12个月后（T12）评价了糖化血红蛋白（HbA 1c %）、每日胰岛素需求量（IU/Kg/天）和IDAA 1c（复合指数，计算为IU/Kg/天x 4 + HbA 1c %）作为REIS的替代指标。在补充omega-3的组中，在T0和T12评价饮食摄入量。作为结果，在补充omega-3的组中发现胰岛素需求减少（p <0.01），特别是餐前推注（p < 0.01）和IDAA 1c（p < 0.01），而HbA 1c %没有显著差异。在T12与T0时，补充omega-3的组中的饮食分析强调花生四烯酸（AA）的摄入量减少（p < 0.01）。在T0时，AA摄入量与HbA 1c %呈负相关（p < 0.05; r;. 0.411）。总之，研究结果表明，维生素D + omega-3联合补充以及地中海饮食中AA的减少对T1 D儿童在发病时显示出益处，值得进一步研究。
Vitamin D and omega 3 fatty acid (omega-3) co-supplementation potentially improves type 1 diabetes (T1D) by attenuating autoimmunity and counteracting inflammation. This cohort study, preliminary to a randomized control trial (RCT), is aimed at evaluating, in a series of T1D children assuming Mediterranean diet and an intake of cholecalciferol of 1000U/day from T1D onset, if omega-3 co-supplementation preserves the residual endogen insulin secretion (REIS). Therefore, the cohort of 22 "new onsets" of 2017 received omega-3 (eicosapentenoic acid (EPA) plus docosahexaenoic acid (DHA), 60 mg/kg/day), and were compared retrospectively vs. the 37 "previous onsets" without omega-3 supplementation. Glicosilated hemoglobin (HbA1c%), the daily insulin demand (IU/Kg/day) and IDAA1c, a composite index (calculated as IU/Kg/day x 4 + HbA1c%), as surrogates of REIS, were evaluated at recruitment (T0) and 12 months later (T12). In the omega-3 supplemented group, dietary intakes were evaluated at T0 and T12. As an outcome, a decreased insulin demand (p < 0.01), particularly as pre-meal boluses (p < 0.01), and IDAA1c (p < 0.01), were found in the omega-3 supplemented group, while HbA1c% was not significantly different. Diet analysis in the omega-3 supplemented group, at T12 vs. T0, highlighted that the intake of arachidonic acid (AA) decreased (p < 0.01). At T0, the AA intake was inversely correlated with HbA1c% (p < 0.05; r;. 0.411). In conclusion, the results suggest that vitamin D plus omega-3 co-supplementation as well as AA reduction in the Mediterranean diet display benefits for T1D children at onset and deserve further investigation.