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Effects of long-term vitamin D and n-3 fatty acid supplementation on inflammatory and cardiac biomarkers in patients with type 2 diabetes: secondary analyses from a randomised controlled trial – published online 24/10/2020

Limonte GA

Christine P. Limonte, Leila R. Zelnick, John Ruzinski, Andrew N. Hoofnagle, Ravi Thadhani, Michal L. Melamed, I-Min Lee, Julie E. Buring, Howard D. Sesso, JoAnn E. Manson, Ian H. de Boer

Immune system activation contributes to the development of diabetes complications. Vitamin D and n-3 fatty acids have been recognised for their anti-inflammatory effects in laboratory models, with mixed evidence from trials in diabetes populations. In this issue, Limonte et al (https://doi.org/10.1007/s00125-020-05300-7) report results of changes in serum concentrations of inflammatory and cardiovascular biomarkers from the Vitamin D and Omega-3 Trial to Prevent and Treat Diabetic Kidney Disease (VITAL-DKD), in which 1312 adults with type 2 diabetes were randomised to supplementation with vitamin D3 (2000 IU/day) and/or n-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid; 1 g/day) or placebo and followed for 5 years. The authors found that supplementation did not lead to a decline in serum levels of IL-6, high-sensitivity C-reactive protein or N-terminal pro-B-type natriuretic peptide. They conclude that this study tilts the balance of available evidence to favour no benefit of these interventions on inflammation and suggests that supplementation is unlikely to have a positive impact on diabetes complications for which inflammation is an underlying cause.

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