Studies in Medical Sciences
مجله مطالعات علوم پزشکی
Studies in Medical Sciences
Medical Sciences
http://umj.umsu.ac.ir
37
journal37
2717-008X
2717-008X
10.61186/umj
fa
jalali
1393
7
1
gregorian
2014
10
1
25
8
online
1
fulltext
fa
تأثیر مکمل یاری توأمان کلسیم و ویتامین D بر شاخصهای متابولیک در افراد دارای سطوح ناکافی ویتامین D سرم و مبتلا به دیابت نوع 2: کارآزمایی بالینی تصادفی کنترلشده
EFFECTS OF CALCIUM-VITAMIN D CO-SUPPLEMENTATION ON METABOLIC PROFILES IN VITAMIN D INSUFFICIENT PEOPLE WITH TYPE 2 DIABETES: A RANDOMIZED CONTROLLED CLINICAL TRIAL
آناتومی
آناتومی
پژوهشي(توصیفی- تحلیلی)
Research
<p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="AR-SA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt">پیشزمینه و هدف:</span></b><span lang="AR-SA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt"> </span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">این مطالعه با هدف بررسی تأثیر مکمل یاری کلسیم و ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> بر شاخصهای متابولیک در افراد مبتلا به دیابت نوع دو که دارای سطوح ناکافی ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> سرم بودند انجام گردید.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">مواد و روش کار:</span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"> در این مطالعه کارآزمایی بالینی تصادفی کنترلشده 118 فرد مبتلا به دیابت نوع 2 شرکت کردند. افراد بهصورت تصادفی به 4 گروه تقسیم شدند. گروه اول هفتهای 50000</span><font size="2"><font face="Times New Roman"><span dir="ltr">IU</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> مکمل ویتامین </span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2">+D</font></span><span dir="rtl"></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> دارونمای کلسیم، گروه دوم روزانه 1000</span><font size="2"><font face="Times New Roman"><span dir="ltr">mg</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> مکمل کلسیم کربنات + دارونمای ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>، گروه سوم روزانه 1000</span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> mg </font></span><span dir="rtl"></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span><font face="Nazanin"><span style="mso-spacerun: yes"><font size="2"> </font></span>کلسیم کربنات و هفتهای 50000</font></span><font size="2"><font face="Times New Roman"><span dir="ltr">IU</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> و گروه چهارم دارونمای ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> و کلسیم به مدت 8 هفته دریافت کردند. جهت ارزیابی شاخصهای متابولیک در ابتدا و انتهای مطالعه از کلیه افراد آزمایش خون گرفته شد.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">یافتهها:</span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"> مکمل یاری توأمان کلسیم و ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> سبب کاهش انسولین سرم</span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2">) </font></span><span dir="rtl"></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>001/0</span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> p= </font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">و </span><font size="2"><font face="Times New Roman"><span dir="ltr">pmol/L</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 9/3±8/14-)، </span><font size="2"><font face="Times New Roman"><span dir="ltr">HbA1C</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> (%19/0±70/0- و 02/0</span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>)، </span><font size="2"><font face="Times New Roman"><span dir="ltr">HOMA-IR</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> (20/0±46/0- و 001/0</span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>)، </span><font size="2"><font face="Times New Roman"><span dir="ltr">LDL</span><span dir="rtl"></span></font></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> <span lang="FA"><font face="Nazanin" size="2">(</font></span></span><font size="2"><font face="Times New Roman"><span dir="ltr">mmol/L</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 1/0±3/10-</span><span dir="ltr"></span><span lang="FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> </font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">و 04/0</span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>) و </span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font size="2"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>total/HDL</font></font></span><span dir="rtl"></span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> <span lang="FA"><font face="Nazanin" size="2">(16/0±91/0-و 03/0</font></span></span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>) در مقایسه با سایر گروهها گردید. همچنین افزایش معنیدار در شاخص </span><font size="2"><font face="Times New Roman"><span dir="ltr">QUICKI</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> (</span><font size="2"><font face="Times New Roman"><span dir="ltr">mmol/L</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 01/0±02/0</span><span dir="ltr"></span><span lang="FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> </font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">و 004/0</span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>) و </span><font face="Times New Roman"><font size="2"><span dir="ltr">HOMA-B </span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span><font face="Nazanin"><span style="mso-spacerun: yes"><font size="2"> </font></span>(</font></span><font size="2"><font face="Times New Roman"><span dir="ltr">mmol/L</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 7/12±8/11</span><span dir="ltr"></span><span lang="FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> </font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">و 001/0</span><font size="2"><font face="Times New Roman"><span dir="ltr">p=</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>) در گروه کلسیم+ ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> در مقایسه با سایر گروهها مشاهده گردید. <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">نتیجهگیری:</span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"> بهطورکلی مکمل یاری توأمان کلسیم و ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> سبب بهبود شاخصهای گلایسمیک و پروفایل لیپیدی در افراد دارای سطح ناکافی ویتامین </span><font size="2"><font face="Times New Roman"><span dir="ltr">D</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> سرم و مبتلا به دیابت نوع 2 میگردد.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><p> </p></span></p>
<p class="Abstract" style="MARGIN: 0in 0in 0pt"><p><strong><font face="Times New Roman" size="3"> </font></strong></p></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><strong><i>Background & Aims</i>: </strong>To the best of our knowledge, no study has examined the effects of vitamin D-calcium co-supplementation on glycemic status and lipid profiles of vitamin D insufficient people with diabetes. This study was performed to assess the effects of vitamin D and</font></font><a name="_GoBack"></a><font size="3"><font face="Times New Roman"> calcium supplementation on metabolic profiles of vitamin D insufficient persons with type 2 diabetes.<b><p></p></b></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i>Materials & Methods</i>: </b>In a randomized placebo controlled clinical trial, a total of 118 persons with vitamin D insufficiency and type 2 diabetes were enrolled. Subjects were randomly assigned into four groups receiving: 1) 50000 IU/wk vitamin D+calcium placebo 2) 1000 mg/d calcium +vitamin D placebo 3) 50000 IU/wk vitamin D+1000 mg/d calcium 4) vitamin D placebo +calcium placebo for 8 weeks. All participants provided three days of dietary records and three days of physical activity records throughout the intervention. Blood samples were taken to quantify metabolic profile sat study baseline and after 8 weeks of intervention. </font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i>Results</i>:</b> Calcium-vitamin D co-supplementation resulted in reduced serum insulin (-14.8±3.9 pmol/L, P=0.01), HbA1c (-0.70±0.19%, P=0.02), HOMA-IR(-0.46±0.20, P=0.001), LDL-(-10.3±0.1 mmol/L, P=0.04) and total/HDL-cholesterol levels (-0.91±0.16, P=0.03) compared with other groups. We found a significant increase in QUICKI index (0.02±0.01, P=0.004), HOMA-B (11.8±12.17, P=0.001) and HDL-cholesterol (0.46±0.05 mmol/L, P=0.03) levels in calcium-vitamin D group compared with others. Vitamin D supplementation led to a significant improvement in all biomarkers of glycemic status, except for fasting plasma glucose, compared with no-vitamin D group.</font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i>Conclusion</i>: </b>Joint calcium-vitamin D supplementation might improve glycemic status and lipid profiles in vitamin D insufficient people with type 2 diabetes. </font></font></p><p align="center" class="Amatnmagale" style="TEXT-ALIGN: center MARGIN: 0in 0in 0pt"><p><font face="Times New Roman" size="3"> </font></p></p><p align="center" class="Amatnmagale" style="TEXT-ALIGN: center MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman">SOURCE: URMIA MED J 2014: 25(8): 705 ISSN: 1027-3727<span style="mso-bidi-language: FA"><p></p></span></font></font></p>
ویتامین D, کلسیم, شاخصهای متابولیکی, دیابت نوع 2
Vitamin D, Calcium, Metabolic profiles, Type 2 diabetes, Glycaemia
693
705
http://umj.umsu.ac.ir/browse.php?a_code=A-10-582-516&slc_lang=fa&sid=1
Marjan
Tabesh
مرجان
تابش
3700319475328460010433
3700319475328460010433
No
Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
مرکز تحقیقات امنیت غذایی، گروه تغذیه جامعه، دانشکده تغذیه و علوم غذایی دانشگاه علوم پزشکی اصفهان
Leila
Azadbakht
لیلا
آزادبخت
3700319475328460010434
3700319475328460010434
No
Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
مرکز تحقیقات امنیت غذایی، گروه تغذیه جامعه، دانشکده تغذیه و علوم غذایی دانشگاه علوم پزشکی اصفهان
Elham
Faghihimani
الهام
فقیه ایمانی
3700319475328460010435
3700319475328460010435
No
, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences,
مرکز تحقیقات غدد ومتابولیسم، دانشگاه علوم پزشکی اصفهان
Maryam
Tabesh
مریم
تابش
3700319475328460010436
3700319475328460010436
No
Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences
دانشکده تغذیه و رژیمهای غذایی، دانشگاه علوم پزشکی تهران
, Ahmad
Esmaillzadeh
احمد
اسماعیلزاده
esmaillzadeh@hlth.mui.ac.ir
3700319475328460010437
3700319475328460010437
Yes
Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan
مرکز تحقیقات امنیت غذایی، گروه تغذیه جامعه، دانشکده تغذیه و علوم غذایی دانشگاه علوم پزشکی اصفهان