Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials
Pittas AG, Kawahara T, Jorde R, Dawson-Hughes B, Vickery EM, Angellotti E, Nelson J, Trikalinos TA, Balk EM
Annals of internal medicine · 132 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2023-02-06 · Ann Intern Med · vol. 176 · número 3 · págs. 355–363
- Editorial
- American College of Physicians
- Citado
- 179 citas · más que el 100% de estudios similares · 29.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 29 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Diabetes Treatment and Management · Bone health and osteoporosis research
- Palabras clave
- vitamin D supplementation, type 2 diabetes prevention, prediabetes, vitamin D3, eldecalcitol, 25-hydroxyvitamin D, kidney stones, hypercalcemia, adverse events, dose-response relationship, vitamin D receptor agonists, vitamin D receptor antagonists
- MeSH
- humans, diabetes mellitus, type 2, prediabetic state, cholecalciferol, glucose, vitamins, vitamin d, dietary supplements, adult, randomized controlled trials as topic
9 autores
- Anastassios G. Pittas🇺🇸Tufts Medical Center
- Tetsuya Kawahara
- Rolf Jorde🇳🇴UiT The Arctic University of Norway
- Bess Dawson‐Hughes🇺🇸Tufts University; Tufts Medical Center; Jean Mayer Human Nutrition Research Center on Aging
- Ellen M. Vickery🇺🇸Tufts Medical Center
- Edith Angellotti
- Jason Nelson🇺🇸Tufts Medical Center
- Thomas A Trikalinos🇺🇸Brown University
- Ethan M. Balk🇺🇸Brown University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The role of vitamin D in people who are at risk for type 2 diabetes remains unclear.
Purpose
To evaluate whether administration of vitamin D decreases risk for diabetes among people with prediabetes.
Data sources
PubMed, Embase, and ClinicalTrials.gov from database inception through 9 December 2022.
Study selection
Eligible trials that were specifically designed and conducted to test the effects of oral vitamin D versus placebo on new-onset diabetes in adults with prediabetes.
Data extraction
The primary outcome was time to event for new-onset diabetes. Secondary outcomes were regression to normal glucose regulation and adverse events. Prespecified analyses (both unadjusted and adjusted for key baseline variables) were conducted according to the intention-to-treat principle.
Data synthesis
Three randomized trials were included, which tested cholecalciferol, 20 000 IU (500 mcg) weekly; cholecalciferol, 4000 IU (100 mcg) daily; or eldecalcitol, 0.75 mcg daily, versus matching placebos. Trials were at low risk of bias. Vitamin D reduced risk for diabetes by 15% (hazard ratio, 0.85 [95% CI, 0.75 to 0.96]) in adjusted analyses, with a 3-year absolute risk reduction of 3.3% (CI, 0.6% to 6.0%). The effect of vitamin D did not differ in prespecified subgroups. Among participants assigned to the vitamin D group who maintained an intratrial mean serum 25-hydroxyvitamin D level of at least 125 nmol/L (≥50 ng/mL) compared with 50 to 74 nmol/L (20 to 29 ng/mL) during follow-up, cholecalciferol reduced risk for diabetes by 76% (hazard ratio, 0.24 [CI, 0.16 to 0.36]), with a 3-year absolute risk reduction of 18.1% (CI, 11.7% to 24.6%). Vitamin D increased the likelihood of regression to normal glucose regulation by 30% (rate ratio, 1.30 [CI, 1.16 to 1.46]). There was no evidence of difference in the rate ratios for adverse events (kidney stones: 1.17 [CI, 0.69 to 1.99]; hypercalcemia: 2.34 [CI, 0.83 to 6.66]; hypercalciuria: 1.65 [CI, 0.83 to 3.28]; death: 0.85 [CI, 0.31 to 2.36]).
Limitations
Studies of people with prediabetes do not apply to the general population. Trials may not have been powered for safety outcomes.
Conclusion
In adults with prediabetes, vitamin D was effective in decreasing risk for diabetes.
Primary funding source
None. (PROSPERO: CRD42020163522).
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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