摘要
糖尿病患病率与日俱增,给社会造成了严重的经济负担。维生素D在骨骼之外的作用逐渐为人们所知。在横断面研究中,维生素D水平与肥胖、2型糖尿病的发病有相关性,但是补充维生素D的前瞻性随机对照临床试验却没有发现维生素D具有防治糖尿病的效果,其原因除与维生素D受体基因型不同有关外,还与药物剂量、疗程等有关。然而,最新的基础研究结果提示,中枢性给予活性维生素D能避免外周给药无效的问题,起到改善高脂喂养大鼠糖代谢的作用。此外,联合应用活性维生素D类似物和BRD9抑制剂,能在染色质水平上使维生素D受体反应元件的可及性增加,更好地起到抑制肥胖和糖尿病小鼠炎症反应、保护胰岛β细胞的作用。有必要不断加强基础研究,探索发挥维生素D及其活性类似物防治2型糖尿病作用的新途径和新方法。
The prevalence of diabetes is increasing rapidly which becomes a serious economic burden to society. The effects of vitamin D beyond bone are increasingly recognized. Circulating level of vitamin D is associated with the development of obesity and type 2 diabetes in cross-sectional human studies. However, as to the therapeutic efficacy of vitamin D supplementation on the prevention of diabetes, the results derived from randomized controlled clinical trials were disappointing, probably due to variations in the vitamin D receptor genotypes, the dosages and courses of vitamin D treatments. However, two recent basic studies found that central administration of active vitamin D can improve glucose metabolism in diet induced obesity rats; and the combining use of active vitamin D analogue and BRD9 inhibitor rendered the chromatin of vitamin D response elements more accessible, thus more efficiently exerted its anti-inflammatory efficacy and protected islet β cell function in obese and diabetic mice models. Thus it is paramount important to explore some new approaches to prevent and treat diabetes with vitamin D and its active analogues.
作者
杨毓莹
刘建民
Yang Yuying;Liu Jianmin(Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2018年第12期992-996,共5页
Chinese Journal of Endocrinology and Metabolism
关键词
维生素D
维生素D受体
糖尿病
2型
Vitamin D
Vitamin D receptor
Diabetes mellitus, type 2
