美国塔夫茨医学中心Anastassios G. Pittas课题组探讨了补充维生素D和预防2型糖尿病的关系。 相关论文于2019年8月8日发表于国际顶尖学术期刊《新英格兰医学杂志》杂志上。

研究团队招募符合糖尿病前期三条血糖标准中的至少两个（空腹血糖水平，100-125 mg/dl；口服75克葡萄糖后2小时水平，140-199 mg/dl；糖化血红蛋白水平，5.7 - 6.4%）且未符合糖尿病诊断标准的成人。无论治疗前的血清25-羟基维生素D水平是多少，这些参与者每天均服用4000 IU的维生素D3或安慰剂。对这些受试者中的新发糖尿病进行分析，目标糖尿病患者数为508例。

2423名参与者被随机分为两组，维生素D组1211名，安慰剂组1212名。到第24个月，维生素D组受试者血清25-羟基维生素D的平均水平为54.3 ng/ml（治疗前为27.7 ng/ml），而安慰剂组为28.8 ng/ml（治疗前为28.2 ng/ml）。在中位随访2.5年后，维生素D组中有293例患者，安慰剂组中有323例患者（分别为每100人年9.39例和10.66例）患上糖尿病。 维生素D与安慰剂的危险比为0.88，两组不良事件发生率无显著差异。而在维生素D不缺乏的2型糖尿病高危人群中，每天服用4000 IU维生素D3并没有显著降低患糖尿病的风险。

据悉，观察性研究支持较低的血25-羟基维生素D水平与2型糖尿病风险相关。然而，补充维生素D是否能降低糖尿病的风险尚不清楚。
 

附：英文原文

Title: Vitamin D Supplementation and Prevention of Type 2 Diabetes

Author: Anastassios G. Pittas, M.D., Bess Dawson-Hughes, M.D., Patricia Sheehan, R.N., M.P.H., M.S., James H. Ware, Ph.D., William C. Knowler, M.D., Dr.P.H., Vanita R. Aroda, M.D., Irwin Brodsky, M.D., Lisa Ceglia, M.D., Chhavi Chadha, M.D., Ranee Chatterjee, M.D., M.P.H., Cyrus Desouza, M.B., B.S., Rowena Dolor, M.D., John Foreyt, Ph.D., Paul Fuss, B.A., Adline Ghazi, M.D., Daniel S. Hsia, M.D., Karen C. Johnson, M.D., M.P.H., Sangeeta R. Kashyap, M.D., Sun Kim, M.D., Erin S. LeBlanc, M.D., M.P.H., Michael R. Lewis, M.D., Emilia Liao, M.D., Lisa M. Neff, M.D., Jason Nelson, M.P.H., Patrick O’Neil, Ph.D., Jean Park, M.D., Anne Peters, M.D., Lawrence S. Phillips, M.D., Richard Pratley, M.D., Philip Raskin, M.D., Neda Rasouli, M.D., David Robbins, M.D., Clifford Rosen, M.D., Ellen M. Vickery, M.S., Myrlene Staten, M.D. for the D2d Research Group*

Issue&Volume: Vol.381 No.6

Abstract:

Observational studies support an association between a low blood 25-hydroxyvitamin D level and the risk of type 2 diabetes. However, whether vitamin D supplementation lowers the risk of diabetes is unknown.

METHODS

We randomly assigned adults who met at least two of three glycemic criteria for prediabetes (fasting plasma glucose level, 100 to 125 mg per deciliter; plasma glucose level 2 hours after a 75-g oral glucose load, 140 to 199 mg per deciliter; and glycated hemoglobin level, 5.7 to 6.4%) and no diagnostic criteria for diabetes to receive 4000 IU per day of vitamin D3 or placebo, regardless of the baseline serum 25-hydroxyvitamin D level. The primary outcome in this time-to-event analysis was new-onset diabetes, and the trial design was event-driven, with a target number of diabetes events of 508.

RESULTS

A total of 2423 participants underwent randomization (1211 to the vitamin D group and 1212 to the placebo group). By month 24, the mean serum 25-hydroxyvitamin D level in the vitamin D group was 54.3 ng per milliliter (from 27.7 ng per milliliter at baseline), as compared with 28.8 ng per milliliter in the placebo group (from 28.2 ng per milliliter at baseline). After a median follow-up of 2.5 years, the primary outcome of diabetes occurred in 293 participants in the vitamin D group and 323 in the placebo group (9.39 and 10.66 events per 100 person-years, respectively). The hazard ratio for vitamin D as compared with placebo was 0.88 (95% confidence interval, 0.75 to 1.04; P=0.12). The incidence of adverse events did not differ significantly between the two groups.

CONCLUSIONS

Among persons at high risk for type 2 diabetes not selected for vitamin D insufficiency, vitamin D3 supplementation at a dose of 4000 IU per day did not result in a significantly lower risk of diabetes than placebo.

DOI: 10.1056/NEJMoa1900906

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1900906