Insulin tsis kam ua lub luag haujlwm tseem ceeb hauv kev tsim cov kab mob uas tsis yog-coholic fatty siab (NAFLD).vitamin DNtxiv nrog rau cov tshuaj insulin tsis kam rau cov neeg mob NAFLD.Cov txiaj ntsig tau tseem tuaj nrog cov txiaj ntsig tsis sib xws.Lub hom phiaj ntawm txoj kev tshawb no yog los ntsuas cov txiaj ntsig ntawm kev kho cov vitamin D ntxiv rau kev txhim kho cov tshuaj insulin hauv cov neeg mob nrog NAFLD.Cov ntaub ntawv tseem ceeb tau txais los ntawm PubMed, Google Scholar, COCHRANE thiab Science Direct databases.Cov kev tshawb fawb tau raug tshuaj xyuas los ntawm kev siv cov teeb meem tas li lossis cov qauv random-effects.Seven cov kev tshawb fawb tsim nyog nrog rau tag nrho ntawm 735 tus neeg koom nrog.Vitamin DKev noj tshuaj ntxiv txhim kho cov tshuaj insulin nyob rau hauv cov neeg mob nrog NAFLD, cim los ntawm kev txo qis hauv Homeostatic Model Kev Ntsuas ntawm Insulin Resistance (HOMA-IR), nrog qhov sib txawv nruab nrab ntawm -1.06 (p = 0.0006; 95% CI -1.66 txog -0.45). Vitamin D supplementation nce serum vitamin D qib nrog qhov sib txawv ntawm 17.45 (p = 0.0002; 95% CI 8.33 txog 26.56).Vitamin Dsupplementation txo qis ALT qib nrog qhov sib txawv nruab nrab ntawm -4.44 (p = 0.02; 95% CI -8.24 txog -0.65).Tsis muaj kev cuam tshuam rau qib AST.Vitamin D supplementation muaj txiaj ntsig zoo rau kev txhim kho cov tshuaj insulin hauv cov neeg mob NAFLD. Kev noj tshuaj ntxiv tuaj yeem txo HOMA-IR hauv cov neeg mob zoo li no.Nws tuaj yeem siv los ua kev kho mob ntxiv rau cov neeg mob NAFLD.
Cov kab mob uas tsis yog-coholic fatty siab (NAFLD) yog ib pab pawg ntawm cov kab mob hauv siab uas muaj cov rog rog 1.Nws yog cov cim los ntawm kev sib txuam ntawm triglycerides hauv hepatocytes, feem ntau nrog kev ua haujlwm necroinflammatory thiab fibrosis (steatohepatitis) 2.Nws tuaj yeem ua rau tsis muaj cawv steatohepatitis (NASH), fibrosis thiab cirrhosis.NAFLD suav hais tias yog ib qho tseem ceeb ntawm cov kab mob siab ntev thiab nws qhov kev nthuav dav tau nce ntxiv, kwv yees li ntawm 25% mus rau 30% ntawm cov neeg laus hauv cov teb chaws tsim kho3,4.Insulin tsis kam, mob, thiab oxidative kev nyuaj siab yog xav tias yog yam tseem ceeb hauv kev loj hlob ntawm NAFLD1.
Lub pathogenesis ntawm NAFLD yog ze ze rau kev tiv thaiv insulin.Raws li cov qauv "ob-ntaus hypothesis", uas feem ntau tshwm sim, insulin tsis kam koom nrog hauv cov txheej txheem "thawj zaug". hepatocytes, qhov twg insulin tsis kam yog xav tias yog ib qho tseem ceeb ua rau kev loj hlob ntawm hepatic steatosis.Qhov "thawj hit" ua rau lub siab tsis zoo rau cov yam ntxwv uas ua rau "thib ob".Nws tuaj yeem ua rau lub siab puas tsuaj, o thiab fibrosis.Production ntawm proinflammatory cytokines, mitochondrial dysfunction, oxidative kev nyuaj siab, thiab lipid peroxidation kuj yog yam tseem ceeb uas yuav ua rau kev loj hlob ntawm daim siab raug mob, tsim los ntawm adipokines.
Vitamin D yog ib tug fat-soluble vitamin uas tswj cov pob txha homeostasis.Nws lub luag hauj lwm tau lug tshawb fawb nyob rau hauv ib tug ntau yam ntawm tsis-skeletal kev mob xws li metabolic syndrome, insulin tsis kam, rog rog, hom 2 mob ntshav qab zib thiab kab mob plawv. Lub cev loj ntawm cov pov thawj tshawb fawb tau tshawb fawb txog kev sib raug zoo ntawm vitamin D thiab NAFLD.Vitamin D paub tias tswj cov tshuaj insulin tsis kam, mob ntev thiab fibrosis.Yog li ntawd, vitamin D yuav pab tiv thaiv kev loj hlob ntawm NAFLD6.
Ntau qhov kev sim tshuaj randomized (RCTs) tau soj ntsuam cov txiaj ntsig ntawm vitamin D supplementation ntawm insulin resistance.Txawm li cas los xij, cov txiaj ntsig tau txais tseem txawv;Txawm hais tias muaj txiaj ntsig zoo ntawm insulin tsis kam lossis tsis pom muaj txiaj ntsig 7,8,9,10,11,12,13.Txawm hais tias muaj kev cuam tshuam tsis sib haum, kev tshuaj xyuas meta yog xav tau los ntsuas tag nrho cov txiaj ntsig ntawm vitamin D supplementation.Muaj ntau cov tshuaj ntsuam xyuas meta. tau ua yav dhau los14,15,16.A meta-kev soj ntsuam los ntawm Guo li al.Nrog rau rau qhov kev tshawb fawb soj ntsuam cov txiaj ntsig ntawm vitamin D ntawm insulin tsis kam muab cov pov thawj tseem ceeb uas cov vitamin D tuaj yeem muaj txiaj ntsig zoo rau insulin rhiab heev14.Txawm li cas los xij, lwm cov meta- Kev soj ntsuam tau txais txiaj ntsig sib txawv.Pramono thiab al15 pom tias kev kho cov vitamin D ntxiv tsis muaj kev cuam tshuam rau insulin rhiab heev.Cov pejxeem suav nrog hauv txoj kev tshawb no yog cov neeg uas muaj lossis muaj kev pheej hmoo ntawm insulin tsis kam, tsis yog cov tsom rau NAFLD.Lwm txoj kev tshawb fawb los ntawm Wei li al. ., suav nrog plaub qhov kev tshawb fawb, ua qhov kev tshawb pom zoo sib xws.Vitamin D supplementation tsis txo HOMA IR16.Xav txog tag nrho cov meta-analyses yav dhau los ntawm kev siv cov vitamin D ntxiv rau cov tshuaj insulin, ib qho updated meta-analysis yog xav tau nrog rau cov ntaub ntawv tshiab ntxiv.Lub hom phiaj ntawm txoj kev tshawb no yog los soj ntsuam cov txiaj ntsig ntawm vitamin D supplementation ntawm insulin tsis kam.
Los ntawm kev siv lub tswv yim tshawb fawb saum toj kawg nkaus, peb pom tag nrho ntawm 207 cov kev tshawb fawb, thiab tom qab deduplication, peb tau txais 199 tsab xov xwm.Peb tsis suav nrog 182 kab lus los ntawm kev tshuaj xyuas cov npe thiab cov lus piav qhia, tawm tag nrho ntawm 17 cov kev tshawb fawb ntsig txog.Cov kev tshawb fawb uas tsis muab tag nrho cov ntaub ntawv. xav tau rau qhov kev tshuaj ntsuam xyuas meta no lossis cov ntawv sau tag nrho tsis suav nrog.Tom qab kev tshuaj xyuas thiab kev soj ntsuam zoo, peb tau txais xya tsab xov xwm rau kev tshuaj xyuas tam sim no thiab meta-analysis.Cov ntawv ntws ntawm PRISMA txoj kev tshawb fawb tau pom hauv daim duab 1 .
Peb suav nrog cov ntawv sau tag nrho ntawm xya qhov kev sim ntsuas randomized (RCTs).Lub xyoo tshaj tawm ntawm cov kab lus no nyob ntawm 2012 txog 2020, nrog rau tag nrho ntawm 423 tus qauv hauv pab pawg cuam tshuam thiab 312 hauv pawg placebo.Cov pab pawg sim tau txais txawv koob tshuaj thiab ntev npaum li cas ntawm cov tshuaj vitamin D, thaum pawg tswj hwm tau txais cov placebo.A cov ntsiab lus ntawm cov kev tshawb fawb thiab cov yam ntxwv ntawm kev kawm tau nthuav tawm hauv Table 1.
Kev pheej hmoo ntawm kev tsis ncaj ncees tau txheeb xyuas siv Cochrane Collaboration txoj kev pheej hmoo ntawm kev tsis ncaj ncees.Tag nrho xya kab lus nyob rau hauv txoj kev tshawb no dhau qhov kev ntsuam xyuas zoo.Cov txiaj ntsig tag nrho ntawm kev pheej hmoo ntawm kev tsis ncaj ncees rau tag nrho cov khoom suav nrog tau piav qhia hauv daim duab 2.
Vitamin D supplementation txhim kho cov tshuaj insulin hauv cov neeg mob uas muaj NAFLD, tus cwj pwm los ntawm kev txo qis HOMA-IR.Raws li tus qauv random teebmeem (I2 = 67%; χ2 = 18.46; p = 0.005), qhov sib txawv ntawm cov vitamin D supplementation thiab tsis muaj vitamin. D supplementation yog -1.06 (p = 0.0006; 95% CI -1.66 rau -0.45) ( duab 3).
Raws li tus qauv random-effects (Daim duab 4), qhov sib txawv ntawm qhov sib txawv ntawm cov vitamin D ntshav tom qab cov vitamin D supplementation yog 17.45 (p = 0.0002; 95% CI 8.33 txog 26.56). Hauv cov ntshav vitamin D theem los ntawm 17.5 ng / mL.Meanwhile, cov nyhuv ntawm vitamin D supplementation ntawm lub siab enzymes ALT thiab AST pom tau tias sib txawv.Vitamin D supplementation txo ALT theem nrog ib tug pooled txhais tau tias sib txawv ntawm -4.44 (p = 0.02; 95% CI -8.24 txog -0.65) (Daim duab 5).Txawm li cas los xij, tsis muaj kev cuam tshuam rau qib AST, nrog qhov sib txawv nruab nrab ntawm -5.28 (p = 0.14; 95% CI - 12.34 txog 1.79) raws li tus qauv random teebmeem ( Daim duab 6).
Kev hloov pauv hauv HOMA-IR tom qab kev ntxiv cov vitamin D tau pom muaj ntau yam heterogeneity (I2 = 67%).Meta-regression kev soj ntsuam ntawm txoj kev tswj hwm (qhov ncauj lossis intramuscular), noj (txhua hnub lossis tsis yog txhua hnub), lossis lub sijhawm ntawm cov vitamin D supplementation (≤ 12 lub lis piam thiab > 12 lub lis piam) qhia tias kev noj ntau zaus tuaj yeem piav qhia txog heterogeneity (Table 2).Tag nrho tab sis ib qho kev tshawb fawb los ntawm Sakpal li al.11 siv txoj hauv kev ntawm qhov ncauj ntawm kev tswj hwm.Txhua hnub noj cov tshuaj vitamin D siv nyob rau hauv peb txoj kev tshawb fawb7,8,13.Ntxiv rhiab heev tsom xam los ntawm kev tawm-ib-tawm tsom xam ntawm cov kev hloov pauv hauv HOMA-IR tom qab cov vitamin D supplementation qhia tias tsis muaj kev tshawb fawb txog lub luag haujlwm. lub heterogeneity ntawm kev hloov hauv HOMA-IR (Fig. 7).
Cov txiaj ntsig sib xyaw ua ke ntawm kev tshuaj ntsuam xyuas tam sim no pom tau tias kev kho cov vitamin D ntxiv tuaj yeem txhim kho cov tshuaj insulin, qhov pom ntawm qhov txo qis HOMA-IR hauv cov neeg mob NAFLD.Txoj kev ntawm kev tswj hwm ntawm vitamin D yuav txawv, los ntawm kev txhaj tshuaj intramuscular lossis los ntawm qhov ncauj. Kev soj ntsuam ntxiv ntawm nws cov txiaj ntsig ntawm kev txhim kho cov tshuaj insulin kom nkag siab txog cov kev hloov hauv cov ntshav ALT thiab AST theem.A txo qis hauv qib ALT, tab sis tsis yog qib AST, tau pom vim muaj cov vitamin D ntxiv.
Qhov tshwm sim ntawm NAFLD yog ze ze rau kev tiv thaiv insulin.Ntau cov fatty acids dawb (FFA), cov ntaub so ntswg adipose o, thiab txo adiponectin yog lub luag haujlwm rau kev txhim kho cov insulin tsis kam hauv NAFLD17.Serum FFA yog nce siab hauv cov neeg mob NAFLD, uas yog tom qab hloov dua siab tshiab. Rau triacylglycerols ntawm glycerol-3-phosphate pathway.Lwm yam khoom ntawm txoj kev no yog ceramide thiab diacylglycerol (DAG).DAG paub tias muaj kev koom tes hauv kev ua kom cov protein kinase C (PKC), uas tuaj yeem cuam tshuam cov insulin receptor threonine 1160, Nws cuam tshuam nrog kev txo qis ntawm cov tshuaj insulin.Cov kab mob ntawm cov ntaub so ntswg adipose thiab nce hauv proinflammatory cytokines xws li interleukin-6 (IL-6) thiab qog necrosis factor alpha (TNF-alpha) kuj ua rau cov tshuaj insulin tsis kam.Rau adiponectin, nws tuaj yeem txhawb nqa inhibition ntawm fatty acid beta-oxidation (FAO), kev siv cov piam thaj thiab fatty acid synthesis.Nws cov qib tau txo qis hauv cov neeg mob NAFLD, yog li txhawb cov dev.Lopment ntawm insulin tsis kam.Kev cuam tshuam rau vitamin D, cov vitamin D receptor (VDR) muaj nyob rau hauv daim siab hlwb thiab tau cuam tshuam los txo cov txheej txheem inflammatory hauv cov kab mob siab ntev.Cov kev ua ntawm VDR nce insulin rhiab heev los ntawm kev hloov FFA.Ntxiv, vitamin D muaj anti-inflammatory thiab anti-fibrotic zog nyob rau hauv daim siab 19.
Cov pov thawj tam sim no qhia tau hais tias vitamin D tsis muaj peev xwm tuaj yeem koom nrog hauv pathogenesis ntawm ntau yam kab mob.Lub tswv yim no muaj tseeb rau kev sib txuas ntawm vitamin D deficiency thiab insulin resistance20,21.Vitamin D siv nws lub peev xwm los ntawm kev cuam tshuam nrog VDR thiab vitamin D metabolizing enzymes. Cov no tuaj yeem muaj nyob hauv ntau hom cell, suav nrog pancreatic beta hlwb thiab cov hlwb ua haujlwm insulin xws li adipocytes.Txawm hais tias qhov tseeb mechanism ntawm vitamin D thiab insulin kuj tseem tsis paub meej, nws tau pom tias cov ntaub so ntswg adipose yuav koom nrog nws cov txheej txheem. Lub khw tseem ceeb ntawm vitamin D nyob rau hauv lub cev yog cov ntaub so ntswg adipose.Nws kuj ua raws li qhov tseem ceeb ntawm adipokines thiab cytokines thiab koom nrog hauv kev tsim cov kab mob hauv lub cev.Cov pov thawj tam sim no qhia tias vitamin D tswj cov xwm txheej cuam tshuam nrog insulin secretion los ntawm pancreatic beta hlwb.
Muab cov pov thawj no, vitamin D supplementation los txhim kho cov tshuaj insulin hauv cov neeg mob NAFLD yog qhov tsim nyog.Cov ntaub ntawv tsis ntev los no taw qhia txog cov txiaj ntsig zoo ntawm cov vitamin D ntxiv rau kev txhim kho cov tshuaj insulin. Ntau RCTs tau muab cov txiaj ntsig tsis sib haum, xav tau kev soj ntsuam ntxiv los ntawm meta-analyses. Kev tshuaj ntsuam meta-tshaj tawm los ntawm Guo thiab al.Kev ntsuam xyuas cov txiaj ntsig ntawm vitamin D ntawm insulin tsis kam muab cov pov thawj tseem ceeb uas cov vitamin D tuaj yeem muaj txiaj ntsig zoo rau insulin rhiab heev.Lawv pom qhov txo qis hauv HOMA-IR ntawm − 1.32;95% CI – 2.30, – 0.34.Cov kev tshawb fawb suav nrog rau kev soj ntsuam HOMA-IR yog rau kev tshawb fawb 14.Txawm li cas los xij, cov pov thawj tsis sib haum xeeb muaj tshwm sim.Ib qho kev tshuaj xyuas thiab kev tshuaj ntsuam meta uas muaj 18 RCTs los ntawm Pramono thiab al soj ntsuam cov txiaj ntsig ntawm vitamin D supplementation ntawm insulin rhiab heev rau cov neeg mob uas muaj cov tshuaj insulin tsis kam lossis kev pheej hmoo ntawm cov tshuaj insulin tau pom tias ntxiv cov vitamin D Insulin rhiab heev tsis muaj txiaj ntsig, tus qauv ntsuas qhov sib txawv -0.01, 95% CI -0.12, 0.10;p = 0.87, I2 = 0% 15.Txawm li cas los xij, nws yuav tsum tau muab sau tseg tias cov pej xeem raug soj ntsuam hauv kev tshuaj ntsuam meta yog cov neeg muaj lossis muaj kev pheej hmoo ntawm insulin tsis kam (hnyav, rog rog, prediabetes, polycystic zes qe menyuam syndrome [PCOS] thiab hom tsis sib xws. 2 mob ntshav qab zib), ntau dua li cov neeg mob NAFLD15.Lwm qhov kev tshuaj ntsuam xyuas los ntawm Wei et al.Cov kev tshawb pom zoo sib xws kuj tau txais.Hauv kev ntsuam xyuas cov vitamin D supplementation hauv HOMA-IR, suav nrog plaub txoj kev tshawb fawb, vitamin D supplementation tsis txo HOMA IR (WMD. = 0.380, 95% CI – 0.162, 0.923; p = 0.169)16.Piv tag nrho cov ntaub ntawv muaj, qhov kev tshuaj xyuas tam sim no thiab kev tshuaj ntsuam xyuas tau muab cov lus ceeb toom ntau ntxiv ntawm cov vitamin D supplementation txhim kho insulin tsis kam hauv cov neeg mob NAFLD, zoo ib yam li cov tshuaj ntsuam xyuas meta. los ntawm Guo et al.Txawm hais tias cov kev soj ntsuam zoo sib xws tau ua tiav, qhov kev tshuaj ntsuam meta tam sim no muab cov ntaub ntawv tshiab uas cuam tshuam nrog kev sim ntau dua thiab yog li muab pov thawj muaj zog rau cov txiaj ntsig ntawm vitamin D supplementation ntawm insulin r.kev cuam tshuam.
Cov txiaj ntsig ntawm vitamin D ntawm kev tiv thaiv insulin tuaj yeem piav qhia los ntawm nws lub luag haujlwm ua tus tswj hwm lub peev xwm ntawm insulin secretion thiab Ca2+ qib.Calcitriol tuaj yeem ua rau cov tshuaj insulin ncaj qha vim tias cov vitamin D cov lus teb (VDRE) muaj nyob rau hauv cov tshuaj insulin txhawb nqa nyob rau hauv pancreatic. Tsis tsuas yog kev hloov pauv ntawm cov tshuaj insulin, tab sis kuj VDRE paub tias yuav txhawb nqa ntau yam genes cuam tshuam nrog kev tsim cytoskeleton, intracellular junctions, thiab cell loj hlob ntawm pancreatic cβ cells.Vitamin D kuj tau pom tias cuam tshuam rau cov tshuaj insulin los ntawm kev hloov Ca2+. Vim tias calcium yog qhov tseem ceeb rau ntau cov txheej txheem insulin-mediated intracellular hauv cov leeg nqaij thiab cov nqaij adipose, vitamin D tuaj yeem koom nrog hauv nws cov nyhuv ntawm insulin tsis kam.Optimal intracellular Ca2+ qib yog qhov tsim nyog rau kev ua haujlwm insulin.Studies tau pom tias vitamin D tsis txaus ua rau nce Ca2 + ntau ntxiv, ua rau txo qis GLUT-4 kev ua haujlwm, uas cuam tshuam rau insulin tsis kam26,27.
Cov txiaj ntsig ntawm vitamin D ntxiv rau kev txhim kho cov tshuaj insulin ntxiv tau txheeb xyuas kom pom nws cov txiaj ntsig ntawm daim siab ua haujlwm, uas tau cuam tshuam txog kev hloov pauv hauv ALT thiab AST theem.A txo qis hauv ALT qib, tab sis tsis yog qib AST, tau pom vim muaj cov vitamin D ntxiv. supplementation.A meta-analysis los ntawm Guo et al.showed ib tug ciam teb txo nyob rau hauv ALT theem, tsis muaj kev cuam tshuam rau qib AST, zoo ib yam li qhov kev tshawb fawb no14.Lwm qhov kev tshawb fawb meta-analysis los ntawm Wei et al.2020 kuj pom tias tsis muaj qhov sib txawv ntawm cov ntshav alanine aminotransferase. thiab aspartate aminotransferase qib ntawm vitamin D supplementation thiab placebo pab pawg.
Kev tshuaj xyuas tam sim no thiab kev tshuaj ntsuam xyuas meta kuj sib cav tawm tsam cov kev txwv.Qhov sib txawv ntawm qhov kev tshuaj ntsuam meta tam sim no tuaj yeem cuam tshuam cov txiaj ntsig tau txais hauv txoj kev tshawb no.Cov kev xav yav tom ntej yuav tsum hais txog cov lej ntawm cov kev tshawb fawb thiab cov ntsiab lus koom nrog hauv kev ntsuam xyuas cov vitamin D supplementation rau insulin tsis kam, Tshwj xeeb yog tsom rau cov neeg NAFLD, thiab qhov sib xws ntawm cov kev tshawb fawb.Lwm yam uas yuav tsum tau xav txog yog los kawm lwm yam tsis muaj nyob hauv NAFLD, xws li cov txiaj ntsig ntawm vitamin D supplementation hauv NAFLD cov neeg mob ntawm cov kab mob inflammatory, NAFLD kev ua tau zoo (NAS) thiab lub siab tawv. Hauv kev xaus, vitamin D supplementation txhim kho cov tshuaj insulin hauv cov neeg mob nrog NAFLD, lub ntsiab lus ntawm kev txo qis HOMA-IR.Nws tuaj yeem siv los ua kev kho mob ntxiv rau cov neeg mob NAFLD.
Cov qauv tsim nyog tau txiav txim siab los ntawm kev ua raws li PICO lub tswv yim.Lub moj khaum tau piav qhia hauv Table 3.
Kev tshuaj xyuas tam sim no thiab ntsuas ntsuas ntsuas suav nrog tag nrho cov kev tshawb fawb txog Lub Peb Hlis 28, 2021, thiab muab cov ntawv sau tag nrho, ntsuas kev tswj hwm vitamin D ntxiv rau cov neeg mob nrog NAFLD.Cov kab lus nrog cov ntaub ntawv ceeb toom, kev tshawb fawb zoo thiab kev lag luam, tshuaj xyuas, cadavers thiab hom cev nqaij daim tawv. tau raug tshem tawm los ntawm txoj kev tshawb fawb tam sim no.Txhua cov ntawv uas tsis muab cov ntaub ntawv xav tau los ua qhov kev tshuaj ntsuam xyuas meta tam sim no kuj raug cais tawm. Txhawm rau tiv thaiv cov qauv luam tawm, cov qauv raug soj ntsuam rau cov ntawv sau los ntawm tib tus sau hauv tib lub tsev kawm ntawv.
Kev tshuaj xyuas suav nrog cov kev tshawb fawb ntawm cov neeg laus NAFLD cov neeg mob tau txais kev tswj hwm vitamin D.Insulin tiv thaiv tau raug soj ntsuam siv Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).
Cov kev cuam tshuam raws li kev tshuaj xyuas yog kev tswj hwm ntawm vitamin D.Peb suav nrog cov kev tshawb fawb uas cov vitamin D tau muab coj los siv ntawm txhua qhov koob tshuaj, los ntawm txhua txoj kev tswj hwm, thiab rau lub sijhawm twg los tau.Txawm li cas los xij, peb tau sau cov koob tshuaj thiab lub sijhawm ntawm cov vitamin D tshuaj hauv txhua qhov kev tshawb fawb. .
Cov txiaj ntsig tseem ceeb tau tshawb xyuas hauv kev tshuaj xyuas tam sim no thiab kev tshuaj ntsuam meta yog insulin tsis kam. Hauv qhov no, peb siv HOMA-IR los txiav txim siab cov tshuaj insulin hauv cov neeg mob. Cov txiaj ntsig thib ob suav nrog cov ntshav vitamin D qib (ng / mL), alanine aminotransferase (ALT). (IU/l) thiab aspartate aminotransferase (AST) (IU/l) ntau ntau.
Extract Eligibility Criteria (PICO) rau hauv cov ntsiab lus uas siv Boolean tus tswv (xws li LOSSIS, THIAB, TSIS TAU) thiab tag nrho cov teb lossis MeSH (Kev Kho Mob Lub taub hau) cov ntsiab lus.Hauv txoj kev tshawb no, peb siv PubMed database, Google Scholar, COCHRANE thiab Science Direct raws li kev tshawb fawb. cov cav tov kom nrhiav tau cov ntawv xov xwm tsim nyog.
Cov txheej txheem kev kawm xaiv tau ua los ntawm peb tus kws sau ntawv (DAS, IKM, GS) kom txo tau qhov muaj peev xwm tshem tawm cov kev tshawb fawb uas muaj feem cuam tshuam.Thaum kev tsis pom zoo tshwm sim, cov kev txiav txim siab ntawm thawj, thib ob thiab thib peb tus kws sau ntawv raug txiav txim siab. Kev xaiv xaiv pib nrog kev tuav duplicate. Cov ntaub ntawv.Title thiab kev tshuaj ntsuam xyuas paub daws teeb meem tau ua kom tsis suav nrog cov kev tshawb fawb tsis sib xws.Tom qab ntawd, cov kev tshawb fawb uas dhau qhov kev ntsuam xyuas thawj zaug tau raug soj ntsuam ntxiv los ntsuam xyuas seb lawv puas ua tau raws li cov txheej txheem suav nrog thiab cais tawm rau qhov kev tshuaj xyuas no.Tag nrho cov kev tshawb fawb tau ua tiav qhov kev ntsuam xyuas zoo ua ntej qhov kawg suav nrog.
Txhua tus kws sau ntawv tau siv cov ntaub ntawv sau cov ntaub ntawv hluav taws xob los sau cov ntaub ntawv xav tau los ntawm txhua kab lus.Cov ntaub ntawv tau muab sau ua ke thiab tswj hwm siv software Review Manager 5.4.
Cov ntaub ntawv yog tus sau lub npe, xyoo ntawm kev tshaj tawm, hom kev kawm, pejxeem, vitamin D koob tshuaj, lub sijhawm ntawm kev tswj hwm vitamin D, tus qauv loj, hnub nyoog, theem pib HOMA-IR, thiab theem pib vitamin D theem. HOMA-IR ua ntej thiab tom qab kev tswj hwm vitamin D tau ua los ntawm kev kho thiab tswj pawg.
Txhawm rau kom ntseeg tau tias tag nrho cov ntawv tau txais txiaj ntsig zoo rau qhov kev tshuaj xyuas no, siv cov cuab yeej ntsuas ntsuas tus qauv tsim nyog.Qhov txheej txheem no, tsim los txo cov peev xwm ntawm kev tsis ncaj ncees hauv kev kawm xaiv, tau ua nws tus kheej los ntawm ob tus kws sau ntawv (DAS thiab IKM).
Cov cuab yeej ntsuas tseem ceeb siv hauv qhov kev tshuaj xyuas no yog Cochrane Collaboration txoj kev pheej hmoo ntawm kev tsis ncaj ncees.
Kev sib xyaw thiab kev txheeb xyuas qhov sib txawv ntawm HOMA-IR nrog thiab tsis muaj vitamin D hauv cov neeg mob nrog NAFLD.Raws li Luo li al., yog tias cov ntaub ntawv tau nthuav tawm raws li qhov nruab nrab lossis ntau yam ntawm Q1 thiab Q3, siv lub tshuab xam zauv los xam qhov nruab nrab. thiab Wan et al.28,29 Cov txiaj ntsig qhov ntau thiab tsawg tau tshaj tawm raws li qhov sib txawv ntawm qhov sib txawv nrog 95% kev ntseeg siab lub sijhawm (CI).Kev tshuaj xyuas tau ua los ntawm kev siv cov qauv tsim kho lossis cov teebmeem random.Heterogeneity tau soj ntsuam siv cov ntaub ntawv I2, qhia tias qhov kev faib ua feem ntawm kev hloov pauv hauv cov kev pom zoo thoob plaws cov kev tshawb fawb yog vim muaj qhov sib txawv ntawm qhov muaj txiaj ntsig zoo, nrog qhov muaj nuj nqis> 60% qhia qhov tseem ceeb ntawm heterogeneity.Yog tias heterogeneity yog> 60%, kev tshuaj xyuas ntxiv tau ua los ntawm kev siv cov meta-regression thiab rhiab heev analyses.Sensitivity analyses tau ua siv txoj kev tawm-ib-tawm. (ib qho kev tshawb fawb ntawm ib lub sij hawm raug muab tshem tawm thiab kev tshuaj ntsuam tau rov ua dua).p-tus nqi <0.05 tau suav tias yog qhov tseem ceeb.Meta-kev tshuaj ntsuam tau ua los ntawm software Review Manager 5.4, kev soj ntsuam rhiab heev tau ua tiav siv cov ntaub ntawv txheeb xyuas software pob (Stata 17.0. rau Windows), thiab meta-regressions tau ua los ntawm Kev Sib Txuas Meta-Tshawb Software Version 3.
Wang, S. et al.Vitamin D supplementation nyob rau hauv kev kho mob ntawm nonalcoholic fatty siab kab mob nyob rau hauv hom 2 mob ntshav qab zib: Cov kev cai rau ib tug systematic tshuaj xyuas thiab meta-analysis.Medicine 99(19), e20148.https://doi.org/10.1097 /MD.0000000000020148 (2020).
Barchetta, I., Cimini, FA & Cavallo, MG Vitamin D supplementation and nonalcoholic fatty liver disease: present and future.Nutrients 9(9), 1015. https://doi.org/10.3390/nu9091015 (2017).
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Paschos, P. & Paletas, K. Cov txheej txheem thib ob hauv cov kab mob uas tsis yog-coholic fatty siab: ib tug multifactorial characterization ntawm tus thib ob-hit.Hippocrates 13 (2), 128 (2009).
Iruzubieta, P., Terran, Á., Crespo, J. & Fabrega, E. Vitamin D deficiency in chronic siab kab mob.World J. Liver Disease.6(12), 901-915.https://doi.org/ 10.4254/wjh.v6.i12.901 (2014).
Amiri, HL, Agah, S., Mousavi, SN, Hosseini, AF & Shidfar, F. Regression ntawm vitamin D supplementation nyob rau hauv nonalcoholic fatty siab kab mob: ib tug ob-dig muag randomized tswj chaw kho mob trial.arch.Iran.medicine.19(9 ), 631-638 (2016).
Bachetta, I. et al.Oral vitamin D supplementation tsis muaj kev cuam tshuam rau cov kab mob uas tsis yog-coholic fatty siab nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib: ib qho randomized, ob-dig muag, placebo-controlled trial.BMC Medicine.14, 92. https://doi .org/10.1186/s12916-016-0638-y (2016).
Foroughi, M., Maghsoudi, Z. & Askari, G. Cov txiaj ntsig ntawm vitamin D supplementation ntawm cov cim sib txawv ntawm cov ntshav qabzib thiab insulin tsis kam nyob rau hauv cov neeg mob uas tsis muaj dej cawv fatty siab kab mob (NAFLD).Iran.J.Nurse.Midwifery Res 21(1), 100-104.https://doi.org/10.4103/1735-9066.174759 (2016).
Hussein, M. et al.Effects ntawm vitamin D supplementation ntawm ntau yam tsis nyob rau hauv cov neeg mob uas tsis muaj dej cawv fatty siab kab mob.Park.J.Pharmacy.science.32 (3 Tshwj Xeeb), 1343–1348 (2019).
Sakpal, M. et al.Vitamin D supplementation nyob rau hauv cov neeg mob uas tsis yog-coholic fatty siab kab mob: ib tug randomized tswj trial.JGH Qhib Qhib Access J. Gastroenterol.heparin.1(2), 62-67.https://doi.org/ 10.1002/jg3.12010 (2017).
Sharifi, N., Amani, R., Hajiani, E. & Cheraghian, B. Puas yog vitamin D txhim kho daim siab enzymes, oxidative stress thiab inflammatory biomarkers nyob rau hauv cov neeg mob uas muaj tus kab mob nonalcoholic fatty siab?A randomized soj ntsuam sim. 70-80.https://doi.org/10.1007/s12020-014-0336-5 (2014).
Wiesner, LZ et al.Vitamin D rau kev kho mob ntawm cov kab mob uas tsis yog-coholic fatty siab raws li kuaj pom los ntawm kev hloov elastography: ib qho kev sib tw, ob qhov muag tsis pom kev, cov placebo-tswj kev sim.Diabetic obesity.metabolism.22(11), 2097-2106.https: //doi.org/10.1111/dom.14129 (2020).
Guo, XF et al.Vitamin D thiab cov kab mob uas tsis yog-coholic fatty siab: ib qho kev tshuaj ntsuam xyuas ntawm randomized controlled trials.food function.11(9), 7389-7399.https://doi.org/10.1039/d0fo01095b (2020).
Pramono, A., Jocken, J., Blaak, EE & van Baak, MA Cov txiaj ntsig ntawm vitamin D supplementation ntawm insulin rhiab heev: kev tshuaj xyuas thiab meta-analysis.Diabetes Care 43(7), 1659–1669.https:// doi.org/10.2337/dc19-2265 (2020).
Wei Y. et al.Effects of vitamin D supplementation nyob rau hauv cov neeg mob uas tsis yog-coholic fatty siab kab mob: ib tug systematic tshuaj xyuas thiab meta-analysis.Interpretation.J.Endocrinology.metabolism.18(3), e97205.https://doi.org/10.5812/ijem.97205 (2020).
Khan, RS, Bril, F., Cusi, K. & Newsome, PN.Modulation of insulin resistance in nonalcoholic fatty liver disease.Hepatology 70(2), 711-724.https://doi.org/10.1002/hep.30429 (2019).
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Post lub sij hawm: May-30-2022