1.
Effects of oral vitamin D supplementation on inflammatory bowel disease: a systematic review and meta-analysis.
Guo, Y, Zhang, T, Wang, Y, Liu, R, Chang, M, Wang, X
Food & function. 2021;(17):7588-7606
Abstract
Vitamin D (VitD) is a fat-soluble micronutrient that plays a critical role in inflammatory bowel disease (IBD). Although the effective properties of VitD in anti-inflammatory and immune moderation were reviewed, some important issues still remain uncovered. Considering the practicability and high bioavailability, as a more recommended therapeutic approach, the effects of oral VitD supplementation on IBD remain inconclusive. This study aims to investigate the effect and safety of oral VitD supplementation on IBD patients, which has already been registered on PROSPERO (no. CRD42020165045). A pooled analysis of 17 trials with 1127 patients revealed that as a safety therapeutic strategy, oral VitD supplementation effectively increased the concentration of serum 25-hydroxyvitamin D [weighted mean difference 12.15 ng mL-1; 95% confidence interval (CI) 9.26, 15.03; I2 = 90%] and decreased serum C-reactive protein levels [standard mean difference (SMD) -0.33; 95% CI -0.61, -0.05; I2 = 55%], but it did not decrease erythrocyte sedimentation rate levels (SMD 0.35; 95% CI -4.33, 5.03; I2 = 57%), disease activity index (SMD -0.13; 95% CI -0.66, 0.39; I2 = 84%) and relapse rate (RR 0.59; 95% CI 0.19, 1.86; I2 = 79%). These findings suggest that oral VitD supplementation has a role to play in the therapeutic management of IBD. These findings may contribute to public health and clinical dietary guidelines and improve the health of IBD patients.
2.
Combined Treatment With Hydrocortisone, Vitamin C, and Thiamine for Sepsis and Septic Shock: A Randomized Controlled Trial.
Chang, P, Liao, Y, Guan, J, Guo, Y, Zhao, M, Hu, J, Zhou, J, Wang, H, Cen, Z, Tang, Y, et al
Chest. 2020;(1):174-182
Abstract
BACKGROUND Whether hydrocortisone, vitamin C, and thiamine treatment can reduce the mortality of patients with sepsis is controversial. RESEARCH QUESTION To evaluate the efficacy and safety of hydrocortisone, vitamin C, and thiamine combination treatment for patients with sepsis or septic shock (HYVCTTSSS). STUDY DESIGN AND METHODS This single-blind, randomized controlled trial evaluated treatment with hydrocortisone (50 mg every 6 h for 7 days), vitamin C (1.5 g every 6 h for 4 days), and thiamine (200 mg every 12 h for 4 days) vs placebo (normal saline) in patients with sepsis. The intention-to-treat analysis was used. Primary outcome was 28-day all-cause mortality, and secondary outcomes were organ protection, procalcitonin reduction, and adverse events related to hydrocortisone, vitamin C, and thiamine. RESULTS Eighty patients were randomized to receive combination treatment (n = 40) or normal saline (n = 40). No difference in 28-day all-cause mortality was observed (27.5% vs 35%, respectively; P = .47); however, treatment was associated with a significant improvement of 72-h change in Sequential Organ Failure Assessment score (P = .02). In adverse events analysis, the treatment group exhibited more incidents of hypernatremia (P = .005). In prespecified subgroup analysis, patients of the treatment subgroup diagnosed with sepsis within 48 h showed lower mortality than those in the control subgroup (P = .02). The study was terminated after the midterm analysis. INTERPRETATION Among patients with sepsis or septic shock, the combination of hydrocortisone, vitamin C, and thiamine did not reduce mortality compared with placebo. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT03258684; URL: www.clinicaltrials.gov.