Long-term vitamin D and high-dose n-3 fatty acids’ supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD

摘要

This study was performed to evaluate the effects of vitamin D and n-3 fatty acids’ co-supplementation on markers of cardiometabolic risk in diabetic patients with CHD. This randomised, double-blinded, placebo-controlled trial was conducted among sixty-one vitamin D-deficient diabetic patients with CHD. At baseline, the range of serum 25-hydroxyvitamin D levels in study participants was 6·3–19·9 ng/ml. Subjects were randomly assigned into two groups either taking 50?000 IU vitamin D supplements every 2 weeks plus 2× 1000 mg/d n-3 fatty acids from flaxseed oil (n 30) or placebo (n 31) for 6 months. Vitamin D and n-3 fatty acids’ co-supplementation significantly reduced mean (P = 0·01) and maximum levels of left carotid intima–media thickness (CIMT) (P = 0·004), and mean (P = 0·02) and maximum levels of right CIMT (P = 0·003) compared with the placebo. In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β ?0·40 mmol/l; 95?% CI ?0·77, ?0·03; P = 0·03), insulin (β ?1·66 μIU/ml; 95?% CI ?2·43, ?0·89; P 0·001), insulin resistance (β ?0·49; 95?% CI ?0·72, ?0·25; P 0·001) and LDL-cholesterol (β ?0·21 mmol/l; 95?% CI ?0·41, ?0·01; P = 0·04), and a significant increase in insulin sensitivity (β +0·008; 95?% CI 0·004, 0·01; P = 0·001) and HDL-cholesterol (β +0·09 mmol/l; 95?% CI 0·01, 0·17; P = 0·02) compared with the placebo. Additionally, high-sensitivity C-reactive protein (β ?1·56 mg/l; 95?% CI ?2·65, ?0·48; P = 0·005) was reduced in the supplemented group compared with the placebo group. Overall, vitamin D and n-3 fatty acids’ co-supplementation had beneficial effects on markers of cardiometabolic risk.