human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The effects of intravenous 1,25 dihydroxycholecalciferol [ (OH)2D3 ] on glucose tolerance and insulin secretion were studied in eleven uremic patients on regular hemodialysis and compared with eleven healthy controls . Intravenous glucose tolerance tests ( IVGTT ) were used to assess glucose tolerance , and the hyperglycemic clamp technique was used to quantitate endogenous insulin secretion . Three days after they had discontinued oral 1,25(OH)2D3 , the dialysis patients were then studied with ( + D ) and without ( -D ) a single intravenous dose of 1,25(OH)2D3 at 2 micrograms/m2 , given two hours before the IVGTT or clamp studies . During the -D studies , the uremic patients were glucose intolerant but not hyperinsulinemic . Intravenous 1,25(OH)2D3 in dialysis patients increased glucose uptake ( K values ) during IVGTT by 38 % ( P less than 0.02 ) and increased early component of insulin secretion during hyperglycemic clamps by 48 % ( P less than 0.01 ) and the late component by 32 % ( P less than 0.01 ) . After intravenous 1,25(OH)2D3 , the dialysis patients became hyperinsulinemic and regained glucose tolerance . Intravenous 1,25(OH)2D3 did not change the K values during IVGTT nor the insulin secretion during hyperglycemic clamps in the control subjects . During the -D studies , serum concentrations of 1,25(OH)2D3 were significantly lower in uremic patients compared with controls . Serum 1,25(OH)2D3 during the + D studies increased to supraphysiological levels in both uremic patients and controls . Serum concentrations of intact parathyroid hormone , total and ionized calcium , magnesium , potassium , urea nitrogen and creatinine were not different between the + D and -D studies in neither the uremic patients nor the controls . These results suggest that 1,25(OH)2D3 deficiency , independent of parathyroid hormone and calcium , may contribute to the abnormalities in glucose tolerance and insulin secretion in dialysis patients CONTEXT Vitamin D is associated with decreased cardiovascular-related morbidity and mortality , possibly by modifying cardiac structure and function , yet firm evidence for either remains lacking . OBJECTIVE To determine the effects of an active vitamin D compound , paricalcitol , on left ventricular mass over 48 weeks in patients with an estimated glomerular filtration rate of 15 to 60 mL/min/1.73 m(2 ) . DESIGN , SETTING , AND PARTICIPANTS Multinational , double-blind , r and omized placebo-controlled trial among 227 patients with chronic kidney disease , mild to moderate left ventricular hypertrophy , and preserved left ventricular ejection fraction , conducted in 11 countries from July 2008 through September 2010 . INTERVENTION Participants were r and omly assigned to receive oral paricalcitol , 2 μg/d ( n = 115 ) , or matching placebo ( n = 112 ) . MAIN OUTCOME MEASURES Change in left ventricular mass index over 48 weeks by cardiovascular magnetic resonance imaging . Secondary end points included echocardiographic changes in left ventricular diastolic function . RESULTS Treatment with paricalcitol  reduced parathyroid hormone levels within 4 weeks and maintained levels within the normal range throughout the study duration . At 48 weeks , the change in left ventricular mass index did not differ between treatment groups ( paricalcitol group , 0.34 g/m(2.7 ) [ 95 % CI , -0.14 to 0.83 g/m(2.7 ) ] vs placebo group , -0.07 g/m(2.7 ) [ 95 % CI , -0.55 to 0.42 g/m(2.7 ) ] ) . Doppler measures of diastolic function including peak early diastolic lateral mitral annular tissue velocity  ( paricalcitol group , -0.01 cm/s [ 95 % CI , -0.63 to 0.60 cm/s ] vs placebo group , -0.30 cm/s [ 95 % CI , -0.93 to 0.34 cm/s ] ) also did not differ . Episodes of hypercalcemia were more frequent in the paricalcitol group compared with the placebo group . CONCLUSION Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in patients with chronic kidney disease . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00497146 The aim of this study was to evaluate the effect of calcitriol treatment on glucose intolerance in uraemia . Thirty one patients on haemodialysis who had never been treated with vitamin D or related drugs , and 12 healthy control subjects with normal renal functions were studied . Uraemic patients were r and omly divided into two groups ; 16 patients were treated with oral calcitriol ( 0.5 micrograms/day ) for 8 weeks , and 15 uraemic patients and 12 healthy subjects were given a placebo . In all these cases , before and 8 weeks after treatment , baseline serum glucose , insulin , calcium , parathormone ( PTH ) , and 1,25 (OH)2D3 were measured . After an oral load of 75 g glucose , blood glucose and insulin  were determined at 30 , 60 , 90 , and 120 min . The same measurements were repeated after 8 weeks . HbA1c and fructosamine were also measured at 0 and 8 weeks . Baseline serum insulin was significantly elevated after calcitriol treatment ( 7.81 versus 11.63 microIU/ml ) there was also a significant increase in insulin following calcitriol treatment at 30 , 60 , 90 , and 120 min . On the other h and , glycosylated haemoglobin ( HbA1c ) and fructosamine decreased after calcitriol treatment ( HbA1c 7.09 % versus 5.22 % P < 0.01 and fructosamine 2.92 versus 2.50 mmol/l P < 0.01 ) . Blood glucose significantly decreased after calcitriol treatment at 0 , 30 , 60 , 90 , and 120 min . In the other two groups there were no significant changes in any parameters . These results seem to confirm that vitamin D influences pancreatic beta ( beta ) cell secretion and suggest that calcitriol may improve glucose intolerance in uraemic haemodialysis patients . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE To more clearly eluci date the conflicting results that have been obtained after oral calcitriol pulse therapy on lipid , glucose , and calcium levels in hemodialysis ( HD ) patients , and to determine safety of oral calcitriol pulse therapy in a combination with calcium carbonate . DESIGN A r and omized , crossover , placebo-controlled study . SETTING HD centers in 3 teaching university hospitals . PATIENTS Forty-eight chronic HD patients . METHODS HD patients were r and omized into 2 groups . Each group ( n = 24 ) , in addition to 4.5 g calcium carbonate daily , received either oral calcitriol pulse therapy or placebo twice weekly at the end of HD , sessions for 3 months , after which the 2 therapeutic groups were crossed-over , and for an additional 3 months , the calcitriol group received placebo , and the placebo group was put on calcitriol .  Serum triglyceride , total cholesterol , low-density lipoprotein cholesterol ( LDL-c ) , high-density lipoprotein cholesterol ( HDL-c ) , total calcium , alkaline phosphatase , proteins , phosphorus , parathyroid hormone ( PTH ) , blood pH , and glucose were measured at r and om and at the end of 3 and 6 months of the trial . RESULTS After calcitriol therapy , triglyceride , serum PTH , total alkaline phosphatase , and fasting blood sugar significantly decreased , but total serum calcium significantly increased , whereas other examined parameters remained unchanged compared with the other groups . Calcium , phosphorus , calcium x phosphorus product , PTH levels , and all of these parameters were optimized in 18 ( 37.5 % ) , 22 ( 45.8 % ) , 34 ( 70.8 % ) , 30 ( 62.5 % ) , and 12 ( % 25 ) cases , respectively , in the calcitriol groups . No significant side effect was seen during the trial . CONCLUSION Our findings indicate that short-term oral calcitriol pulse therapy in combination with calcium carbonate is safe and beneficial for metabolic abnormalities of HD patients ; however , its safety for prolonged therapy is yet to be proved 1 . Secondary hyperparathyroidism in chronic renal failure may contribute to abnormalities of lipid metabolism and glucose tolerance . Amelioration of secondary hyperparathyroidism has been reported to mitigate the hyperlipidaemia and improve glucose tolerance experimentally . 2 . The effect of the partial suppression of hyperparathyroidism by intravenous calcitriol on lipid levels and glucose tolerance was studied in 15 haemodialysis patients with secondary hyperparathyroidism . All received intravenous calcitriol 1 microgram at the end of haemodialysis thrice weekly for eight weeks . Oral glucose tolerance test and plasma lipid profiles including triglyceride , total cholesterol , high density lipoprotein cholesterol ( HDL-C ) , low density lipoprotein cholesterol ( LDL-C ) , apoprotein A-I and apoprotein B were determined simultaneously before and after eight weeks of therapy . 3 . Before calcitriol treatment , uraemic patients with secondary hyperparathyroidism displayed a significant higher triglyceride and a significant lower HDL-C and apoprotein A-I as well as marked glucose intolerance with an increment of the area below the glucose curve when compared with healthy control subjects . 4 . After eight weeks of calcitriol treatment , there was a significant decrement in serum intact parathyroid hormone ( 476.45 + /- 48.33 versus 191.37 + /- 30.17 ng/l , P < 0.001 ) and plasma triglyceride ( 2.24 + /- 0.34 versus 1.80 + /- 0.29 mmol/l , P < 0.05 ) as well as a significant increment of plasma apoprotein A-I ( 38.13 + /- 2.14 versus 44.19 + /- 2.18 mumol/l , P < 0.05 ) , whereas there was no significant change in serum total cholesterol , LDL-C , HDL-C , and apoprotein B. ( ABSTRACT TRUNCATED AT 250 WORDS Introduction : Many studies support the role of vitamin D in the pathogenesis of both types of diabetes . Pancreatic tissues express the vitamin D receptor ( VDR ) and vitamin D-binding protein ; some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose intolerance , defective insulin secretion , and sensitivity . Epidemiological links have been established between type 2 diabetes mellitus ( DM ) and hepatitis C virus ( HCV ) infection . Aim : To explore the possible therapeutic potential of pharmacologic doses of 1-α-hydroxy vitamin D therapy in improving pancreatic β-cell function in HCV seropositive hemodialysis ( HD ) patients . Patients and methods : Twenty HCV seropositive HD patients and 20 HCV seronegative patients as control group were r and omly selected from HD units .  1-α-Hydroxy vitamin D therapy was administrated in the dose ranged from 0.25 to 0.5 μg/day for 3 months  . Corrected total serum calcium , phosphorus , intact parathyroid hormone ( iPTH ) , 25-hydroxy vitamin D [ 25(OH ) vitamin D ] , 1,25-dihydroxy vitamin D , and glucoparameters [ fasting blood glucose , glycohemoglobin test ( HbA1c% ) , homeostatic model assessment (HOMA)-insulin resistance , and HOMA-β-cell function% ( B% ) ] were measured under basal conditions and after 3 months of therapy . Results : There was highly significant improvement in the concentrations of fetal bovine serum ( FBS ) , serum insulin , HbA1c% , 25(OH ) vitamin D , and HOMA-β-cell function in HCV seropositive and HCV seronegative groups after oral 1-alphacalcidiol therapy ( p < 0.001 ) . Positive correlation exists between the percentage increase in serum insulin and that in HOMA-β-cell function versus 25(OH ) vitamin D ( p < 0.021 and p < 0.02 
    Output:
    
agent
Conclusions Short-term ( 4–12 weeks ) supplementation with vitamin D is associated with lower fasting glucose levels in ESRD with no change in fasting insulin levels .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The effects of intravenous 1,25 dihydroxycholecalciferol [ (OH)2D3 ] on glucose tolerance and insulin secretion were studied in eleven uremic patients on regular hemodialysis and compared with eleven healthy controls . Intravenous glucose tolerance tests ( IVGTT ) were used to assess glucose tolerance , and the hyperglycemic clamp technique was used to quantitate endogenous insulin secretion . Three days after they had discontinued oral 1,25(OH)2D3 , the dialysis patients were then studied with ( + D ) and without ( -D ) a single intravenous dose of 1,25(OH)2D3 at 2 micrograms/m2 , given two hours before the IVGTT or clamp studies . During the -D studies , the uremic patients were glucose intolerant but not hyperinsulinemic . Intravenous 1,25(OH)2D3 in dialysis patients increased glucose uptake ( K values ) during IVGTT by 38 % ( P less than 0.02 ) and increased early component of insulin secretion during hyperglycemic clamps by 48 % ( P less than 0.01 ) and the late component by 32 % ( P less than 0.01 ) . After intravenous 1,25(OH)2D3 , the dialysis patients became hyperinsulinemic and regained glucose tolerance . Intravenous 1,25(OH)2D3 did not change the K values during IVGTT nor the insulin secretion during hyperglycemic clamps in the control subjects . During the -D studies , serum concentrations of 1,25(OH)2D3 were significantly lower in uremic patients compared with controls . Serum 1,25(OH)2D3 during the + D studies increased to supraphysiological levels in both uremic patients and controls . Serum concentrations of intact parathyroid hormone , total and ionized calcium , magnesium , potassium , urea nitrogen and creatinine were not different between the + D and -D studies in neither the uremic patients nor the controls . These results suggest that 1,25(OH)2D3 deficiency , independent of parathyroid hormone and calcium , may contribute to the abnormalities in glucose tolerance and insulin secretion in dialysis patients CONTEXT Vitamin D is associated with decreased cardiovascular-related morbidity and mortality , possibly by modifying cardiac structure and function , yet firm evidence for either remains lacking . OBJECTIVE To determine the effects of an active vitamin D compound , paricalcitol , on left ventricular mass over 48 weeks in patients with an estimated glomerular filtration rate of 15 to 60 mL/min/1.73 m(2 ) . DESIGN , SETTING , AND PARTICIPANTS Multinational , double-blind , r and omized placebo-controlled trial among 227 patients with chronic kidney disease , mild to moderate left ventricular hypertrophy , and preserved left ventricular ejection fraction , conducted in 11 countries from July 2008 through September 2010 . INTERVENTION Participants were r and omly assigned to receive oral paricalcitol , 2 μg/d ( n = 115 ) , or matching placebo ( n = 112 ) . MAIN OUTCOME MEASURES Change in left ventricular mass index over 48 weeks by cardiovascular magnetic resonance imaging . Secondary end points included echocardiographic changes in left ventricular diastolic function . RESULTS Treatment with paricalcitol  reduced parathyroid hormone levels within 4 weeks and maintained levels within the normal range throughout the study duration . At 48 weeks , the change in left ventricular mass index did not differ between treatment groups ( paricalcitol group , 0.34 g/m(2.7 ) [ 95 % CI , -0.14 to 0.83 g/m(2.7 ) ] vs placebo group , -0.07 g/m(2.7 ) [ 95 % CI , -0.55 to 0.42 g/m(2.7 ) ] ) . Doppler measures of diastolic function including peak early diastolic lateral mitral annular tissue velocity  ( paricalcitol group , -0.01 cm/s [ 95 % CI , -0.63 to 0.60 cm/s ] vs placebo group , -0.30 cm/s [ 95 % CI , -0.93 to 0.34 cm/s ] ) also did not differ . Episodes of hypercalcemia were more frequent in the paricalcitol group compared with the placebo group . CONCLUSION Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in patients with chronic kidney disease . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00497146 The aim of this study was to evaluate the effect of calcitriol treatment on glucose intolerance in uraemia . Thirty one patients on haemodialysis who had never been treated with vitamin D or related drugs , and 12 healthy control subjects with normal renal functions were studied . Uraemic patients were r and omly divided into two groups ; 16 patients were treated with oral calcitriol ( 0.5 micrograms/day ) for 8 weeks , and 15 uraemic patients and 12 healthy subjects were given a placebo . In all these cases , before and 8 weeks after treatment , baseline serum glucose , insulin , calcium , parathormone ( PTH ) , and 1,25 (OH)2D3 were measured . After an oral load of 75 g glucose , blood glucose and insulin  were determined at 30 , 60 , 90 , and 120 min . The same measurements were repeated after 8 weeks . HbA1c and fructosamine were also measured at 0 and 8 weeks . Baseline serum insulin was significantly elevated after calcitriol treatment ( 7.81 versus 11.63 microIU/ml ) there was also a significant increase in insulin following calcitriol treatment at 30 , 60 , 90 , and 120 min . On the other h and , glycosylated haemoglobin ( HbA1c ) and fructosamine decreased after calcitriol treatment ( HbA1c 7.09 % versus 5.22 % P < 0.01 and fructosamine 2.92 versus 2.50 mmol/l P < 0.01 ) . Blood glucose significantly decreased after calcitriol treatment at 0 , 30 , 60 , 90 , and 120 min . In the other two groups there were no significant changes in any parameters . These results seem to confirm that vitamin D influences pancreatic beta ( beta ) cell secretion and suggest that calcitriol may improve glucose intolerance in uraemic haemodialysis patients . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE To more clearly eluci date the conflicting results that have been obtained after oral calcitriol pulse therapy on lipid , glucose , and calcium levels in hemodialysis ( HD ) patients , and to determine safety of oral calcitriol pulse therapy in a combination with calcium carbonate . DESIGN A r and omized , crossover , placebo-controlled study . SETTING HD centers in 3 teaching university hospitals . PATIENTS Forty-eight chronic HD patients . METHODS HD patients were r and omized into 2 groups . Each group ( n = 24 ) , in addition to 4.5 g calcium carbonate daily , received either oral calcitriol pulse therapy or placebo twice weekly at the end of HD , sessions for 3 months , after which the 2 therapeutic groups were crossed-over , and for an additional 3 months , the calcitriol group received placebo , and the placebo group was put on calcitriol .  Serum triglyceride , total cholesterol , low-density lipoprotein cholesterol ( LDL-c ) , high-density lipoprotein cholesterol ( HDL-c ) , total calcium , alkaline phosphatase , proteins , phosphorus , parathyroid hormone ( PTH ) , blood pH , and glucose were measured at r and om and at the end of 3 and 6 months of the trial . RESULTS After calcitriol therapy , triglyceride , serum PTH , total alkaline phosphatase , and fasting blood sugar significantly decreased , but total serum calcium significantly increased , whereas other examined parameters remained unchanged compared with the other groups . Calcium , phosphorus , calcium x phosphorus product , PTH levels , and all of these parameters were optimized in 18 ( 37.5 % ) , 22 ( 45.8 % ) , 34 ( 70.8 % ) , 30 ( 62.5 % ) , and 12 ( % 25 ) cases , respectively , in the calcitriol groups . No significant side effect was seen during the trial . CONCLUSION Our findings indicate that short-term oral calcitriol pulse therapy in combination with calcium carbonate is safe and beneficial for metabolic abnormalities of HD patients ; however , its safety for prolonged therapy is yet to be proved 1 . Secondary hyperparathyroidism in chronic renal failure may contribute to abnormalities of lipid metabolism and glucose tolerance . Amelioration of secondary hyperparathyroidism has been reported to mitigate the hyperlipidaemia and improve glucose tolerance experimentally . 2 . The effect of the partial suppression of hyperparathyroidism by intravenous calcitriol on lipid levels and glucose tolerance was studied in 15 haemodialysis patients with secondary hyperparathyroidism . All received intravenous calcitriol 1 microgram at the end of haemodialysis thrice weekly for eight weeks . Oral glucose tolerance test and plasma lipid profiles including triglyceride , total cholesterol , high density lipoprotein cholesterol ( HDL-C ) , low density lipoprotein cholesterol ( LDL-C ) , apoprotein A-I and apoprotein B were determined simultaneously before and after eight weeks of therapy . 3 . Before calcitriol treatment , uraemic patients with secondary hyperparathyroidism displayed a significant higher triglyceride and a significant lower HDL-C and apoprotein A-I as well as marked glucose intolerance with an increment of the area below the glucose curve when compared with healthy control subjects . 4 . After eight weeks of calcitriol treatment , there was a significant decrement in serum intact parathyroid hormone ( 476.45 + /- 48.33 versus 191.37 + /- 30.17 ng/l , P < 0.001 ) and plasma triglyceride ( 2.24 + /- 0.34 versus 1.80 + /- 0.29 mmol/l , P < 0.05 ) as well as a significant increment of plasma apoprotein A-I ( 38.13 + /- 2.14 versus 44.19 + /- 2.18 mumol/l , P < 0.05 ) , whereas there was no significant change in serum total cholesterol , LDL-C , HDL-C , and apoprotein B. ( ABSTRACT TRUNCATED AT 250 WORDS Introduction : Many studies support the role of vitamin D in the pathogenesis of both types of diabetes . Pancreatic tissues express the vitamin D receptor ( VDR ) and vitamin D-binding protein ; some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose intolerance , defective insulin secretion , and sensitivity . Epidemiological links have been established between type 2 diabetes mellitus ( DM ) and hepatitis C virus ( HCV ) infection . Aim : To explore the possible therapeutic potential of pharmacologic doses of 1-α-hydroxy vitamin D therapy in improving pancreatic β-cell function in HCV seropositive hemodialysis ( HD ) patients . Patients and methods : Twenty HCV seropositive HD patients and 20 HCV seronegative patients as control group were r and omly selected from HD units .  1-α-Hydroxy vitamin D therapy was administrated in the dose ranged from 0.25 to 0.5 μg/day for 3 months  . Corrected total serum calcium , phosphorus , intact parathyroid hormone ( iPTH ) , 25-hydroxy vitamin D [ 25(OH ) vitamin D ] , 1,25-dihydroxy vitamin D , and glucoparameters [ fasting blood glucose , glycohemoglobin test ( HbA1c% ) , homeostatic model assessment (HOMA)-insulin resistance , and HOMA-β-cell function% ( B% ) ] were measured under basal conditions and after 3 months of therapy . Results : There was highly significant improvement in the concentrations of fetal bovine serum ( FBS ) , serum insulin , HbA1c% , 25(OH ) vitamin D , and HOMA-β-cell function in HCV seropositive and HCV seronegative groups after oral 1-alphacalcidiol therapy ( p < 0.001 ) . Positive correlation exists between the percentage increase in serum insulin and that in HOMA-β-cell function versus 25(OH ) vitamin D ( p < 0.021 and p < 0.02 
    Output:
    