Vitamin D supplementation on prediabetic adults with vitamin D deficiency: a double-blind placebo-controlled randomized clinical trial

Md Habibul Ghani, Md Shahed Morshed, T. Haq, S. Selim, Murshed Ahamed Khan, M. Mustari, Mostafa Hasan Rajib, A. Yadav, I. Faisal, A. Shah, Md Firoj Hossain, M. Hasanat, M. Fariduddin
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Abstract

Hypovitaminosis D (<20 ng/mL) is thought to increase insulin resistance and meta-inflammation contributing to the pathogenesis of diabetes mellitus (DM). Correcting vitamin D deficiency in people with prediabetes might halt its progression to DM. The aim of this study was to examine the effect of vitamin D supplementation on insulin resistance, glycemic status, and inflammation in prediabetic adults with vitamin D deficiency. This doubleblind randomized placebo-controlled trial was done among 27 newly detected prediabetic adults with hypovitaminosis D randomly assigned to 60,000 IU of vitamin D weekly for eight weeks followed by monthly for the next four months or placebo along with lifestyle modification in both groups [vitamin D (n= 14) vs. Placebo (n=13). They were comparable in terms of sex, age and borlymass index. Glycemic status, fasting plasma glucose (FPG) and Hemoglobin A1C (HbA1C), insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR) and inflammatory marker high sensitivity C reactive protein (hs-CRP) were measured at baseline and after six months of intervention. Vitamin D levels (ng/mL) increased in both groups from baseline (vitamin D vs. placebo: 12.2±5.9 vs. 3.9±3.5, mean±SD). FPG (mmol/L) significantly decreased in the Vitamin D group (before vs. after: 5.9±0.6 vs. 5.5±0.7, P=0.016, mean±SD), whereas HbA1C (%) and hs- CRP (mg/L) significantly increased in the placebo group (before vs. after- HbA1C: 5.8±0.3 vs. 6.0±0.4, P<0.001; hs-CRP: 5.0±4.4 vs. 5.6±4.9, P=0.039, mean±SD). Percent changes in glycemic status, HOMA-IR, and hs-CRP were statistically similar between the groups. Our study failed to demonstrate the positive effects of vitamin D supplementation on reducing glucose, insulin resistance, or inflammatory marker in prediabetic adult patients with hypovitaminosis D. BSMMU J 2022; 15(3): 167-174
补充维生素D治疗糖尿病前期维生素D缺乏症的成人:一项双盲安慰剂对照随机临床试验
维生素D缺乏(<20 ng/mL)被认为会增加胰岛素抵抗和亚炎症,从而导致糖尿病(DM)的发病机制。纠正糖尿病前期患者的维生素D缺乏可能会阻止其发展为糖尿病。本研究的目的是检验维生素D补充对患有维生素D缺乏症的糖尿病前期成年人的胰岛素抵抗、血糖状况和炎症的影响。这项双盲随机安慰剂对照试验是在27名新发现的患有低维生素D的糖尿病前期成年人中进行的,他们被随机分配到每周60000 IU的维生素D,持续八周,然后在接下来的四个月内每月服用一次,或在两组中服用安慰剂并改变生活方式[维生素D(n=14)vs。安慰剂(n=13)。他们在性别、年龄和体重指数方面具有可比性。在基线和干预6个月后测量血糖状况、空腹血糖(FPG)和血红蛋白A1C(HbA1C)、胰岛素抵抗(胰岛素抵抗稳态模型评估(HOMA-IR))和炎症标志物高敏C反应蛋白(hs-CRP)。两组的维生素D水平(ng/mL)均较基线增加(维生素D与安慰剂相比:12.2±5.9 vs.3.9±3.5,平均值±SD)。维生素D组的FPG(mmol/L)显著降低(前后:5.9±0.6 vs.5.5±0.7,P=0.016,平均值±SD),而安慰剂组的HbA1C(%)和hs-CRP(mg/L)显著增加(前后:HbA1C:5.8±0.3 vs.6.0±0.4,P<0.001;hs-CRP:5.0±4.4 vs.5.6±4.9,P=0.039,平均值?SD)。两组之间血糖状态、HOMA-IR和hs-CRP的百分比变化在统计学上相似。我们的研究未能证明补充维生素D对降低糖尿病前期低维生素血症成年患者的葡萄糖、胰岛素抵抗或炎症标志物的积极作用;15(3):167-174
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