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A novel mechanism of vitamin D anti-inflammatory/antioxidative potential in type 2 diabetic patients on metformin therapy.
Archives of Medical Science ( IF 3.8 ) Pub Date : 2020-02-04 , DOI: 10.5114/aoms.2020.92832 Milena Cojic 1 , Radivoj Kocic 2 , Aleksandra Klisic 1 , Ljiljana Cvejanov-Kezunovic 1 , Nebojsa Kavaric 1 , Gordana Kocic 3
Archives of Medical Science ( IF 3.8 ) Pub Date : 2020-02-04 , DOI: 10.5114/aoms.2020.92832 Milena Cojic 1 , Radivoj Kocic 2 , Aleksandra Klisic 1 , Ljiljana Cvejanov-Kezunovic 1 , Nebojsa Kavaric 1 , Gordana Kocic 3
Affiliation
Introduction
The performed study focused on determining the effect of vitamin D supplementation on enzymes involved in both inflammation and reactive oxygen species (ROS) production and ROS degradation in patients with type 2 diabetes mellitus (T2DM).
Material and methods
The 6-month follow-up, randomized, controlled study included 140 patients with T2DM, ⥠30 years old, with good metabolic control, treated with metformin and lifestyle advice only. All patients were randomly assigned to two groups (70 each). Patients from the first group (Intervention group) were assigned to receive vitamin D3 50 000 IU or 14 000 IU regarding their vitamin D baseline levels. Patients from the second (Metformin) group continued to receive only metformin during the 6-month study period.
Results
After 6 months, the myeloperoxidase activity was significantly lower and gradually decreased in the Intervention group by about 40%, compared to the baseline measurement (p = 0.015) and compared to the Metformin group (p = 0.001). After 6 months, the xanthine oxidase (XO) activity decreased significantly in the Intervention group compared to the baseline and 3rd month levels (p < 0.001). In the Metformin group there was also a significant decrease in XO after 6 months compared to baseline (p < 0.001) and the 3rd month (p = 0.003). The catalase activity significantly increased within the Intervention group only when comparing the 3rd and 6th month (p = 0.027).
Conclusions
Our study showed that vitamin D may improve endothelial dysfunction in patients with T2DM on metformin therapy by influencing two important factors implicated in the pathogenesis of diabetic complications â ROS production and inflammation, which can additionally contribute to a stable metabolic control during metformin therapy.
中文翻译：
二甲双胍治疗的 2 型糖尿病患者维生素 D 抗炎/抗氧化潜力的新机制。
引言
所进行的研究侧重于确定补充维生素 D 对 2 型糖尿病 (T2DM) 患者参与炎症和活性氧 (ROS) 产生和 ROS 降解的酶的影响。
材料和方法
为期 6 个月的随访、随机、对照研究包括 140 名 T2DM 患者，≥ 30 岁，代谢控制良好，仅接受二甲双胍治疗和生活方式建议。所有患者被随机分配到两组（每组 70 人）。第一组（干预组）的患者被分配接受维生素 D3 50 000 IU 或 14 000 IU 的维生素 D 基线水平。第二组（二甲双胍）的患者在 6 个月的研究期间继续仅接受二甲双胍。
结果
6 个月后，与基线测量值 (p = 0.015) 和二甲双胍组 (p = 0.001) 相比，干预组的髓过氧化物酶活性显着降低并逐渐降低约 40%。6 个月后，与基线和第 3 个月水平相比，干预组的黄嘌呤氧化酶 (XO) 活性显着下降 (p < 0.001)。与基线 (p < 0.001) 和第 3 个月 (p = 0.003) 相比，二甲双胍组 6 个月后 XO 也显着下降。仅在比较第 3 个月和第 6 个月时，干预组内的过氧化氢酶活性显着增加（p = 0.027）。
结论
我们的研究表明，维生素 D 可能通过影响与糖尿病并发症发病机制有关的两个重要因素——ROS 的产生和炎症，来改善二甲双胍治疗的 T2DM 患者的内皮功能障碍，这还有助于二甲双胍治疗期间稳定的代谢控制。
更新日期：2020-02-04
The performed study focused on determining the effect of vitamin D supplementation on enzymes involved in both inflammation and reactive oxygen species (ROS) production and ROS degradation in patients with type 2 diabetes mellitus (T2DM).
Material and methods
The 6-month follow-up, randomized, controlled study included 140 patients with T2DM, ⥠30 years old, with good metabolic control, treated with metformin and lifestyle advice only. All patients were randomly assigned to two groups (70 each). Patients from the first group (Intervention group) were assigned to receive vitamin D3 50 000 IU or 14 000 IU regarding their vitamin D baseline levels. Patients from the second (Metformin) group continued to receive only metformin during the 6-month study period.
Results
After 6 months, the myeloperoxidase activity was significantly lower and gradually decreased in the Intervention group by about 40%, compared to the baseline measurement (p = 0.015) and compared to the Metformin group (p = 0.001). After 6 months, the xanthine oxidase (XO) activity decreased significantly in the Intervention group compared to the baseline and 3rd month levels (p < 0.001). In the Metformin group there was also a significant decrease in XO after 6 months compared to baseline (p < 0.001) and the 3rd month (p = 0.003). The catalase activity significantly increased within the Intervention group only when comparing the 3rd and 6th month (p = 0.027).
Conclusions
Our study showed that vitamin D may improve endothelial dysfunction in patients with T2DM on metformin therapy by influencing two important factors implicated in the pathogenesis of diabetic complications â ROS production and inflammation, which can additionally contribute to a stable metabolic control during metformin therapy.
中文翻译：
二甲双胍治疗的 2 型糖尿病患者维生素 D 抗炎/抗氧化潜力的新机制。
引言
所进行的研究侧重于确定补充维生素 D 对 2 型糖尿病 (T2DM) 患者参与炎症和活性氧 (ROS) 产生和 ROS 降解的酶的影响。
材料和方法
为期 6 个月的随访、随机、对照研究包括 140 名 T2DM 患者，≥ 30 岁，代谢控制良好，仅接受二甲双胍治疗和生活方式建议。所有患者被随机分配到两组（每组 70 人）。第一组（干预组）的患者被分配接受维生素 D3 50 000 IU 或 14 000 IU 的维生素 D 基线水平。第二组（二甲双胍）的患者在 6 个月的研究期间继续仅接受二甲双胍。
结果
6 个月后，与基线测量值 (p = 0.015) 和二甲双胍组 (p = 0.001) 相比，干预组的髓过氧化物酶活性显着降低并逐渐降低约 40%。6 个月后，与基线和第 3 个月水平相比，干预组的黄嘌呤氧化酶 (XO) 活性显着下降 (p < 0.001)。与基线 (p < 0.001) 和第 3 个月 (p = 0.003) 相比，二甲双胍组 6 个月后 XO 也显着下降。仅在比较第 3 个月和第 6 个月时，干预组内的过氧化氢酶活性显着增加（p = 0.027）。
结论
我们的研究表明，维生素 D 可能通过影响与糖尿病并发症发病机制有关的两个重要因素——ROS 的产生和炎症，来改善二甲双胍治疗的 T2DM 患者的内皮功能障碍，这还有助于二甲双胍治疗期间稳定的代谢控制。
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