Effect of Vitamin D Supplementation on Markers of Vascular Function: A Systematic Review and Individual Participant Meta‐Analysis

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

卷:7

Graham A. Hitman¹  Carmine Zoccali²  Jane Armitage³  Robert Clarke³  Hans Stricker⁴  Rajesh Khadgawat⁵  Marina Shargorodsky⁶  Maria Gisella Cavallo⁷  Ilaria Barchetta⁷  Stefan Pilz⁸  Peter Marckmann⁹  Louise A. Beveridge¹⁰  Gavin Dreyer¹¹  Iain Bressendorff¹²  Alexandra Scholze¹³  Ryan A. Harris¹⁴  Seth I. Sokol¹⁵  Nita G. Forouhi¹⁶  Faisel Khan¹⁷  Allan D. Struthers¹⁷  Miles D. Witham¹⁷  Rinkoo Dalan¹⁸  Thomas Larsen¹⁹  Frank H. Mose¹⁹  Adam D. Gepner²⁰ 

[1] Blizard Institute, Queen Mary University of London, United Kingdom;

[2] CNR‐IFC Clinical Epidemiology and Pathphysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy;

[3] Clinical Trial Service Unit and MRC Population Health Research Unit, University of Oxford, United Kingdom;

[4] Department of Angiology, Ospedale La Carita, Locarno, Switzerland;

[5] Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India;

[6] Department of Endocrinology, Wolfson Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;

[7] Department of Experimental Medicine, Sapienza University of Rome, Italy;

[8] Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Austria;

[9] Department of Internal Medicine, Zealand University Hospital, Roskilde, Denmark;

[10] Department of Medicine for the Elderly, NHS Tayside, Dundee, United Kingdom;

[11] Department of Nephrology, Barts Health NHS Trust, London, United Kingdom;

[12] Department of Nephrology, Herlev and Gentofte Hospital, Copenhagen, Denmark;

[13] Department of Nephrology, Odense University Hospital and Institute of Clinical Research University of Southern Denmark, Odense, Denmark;

[14] Department of Population Health Science, Georgia Prevention Institute Augusta University, Augusta, Georgia, USA;

[15] Division of Cardiology, Jacobi Medical Center, NY;

[16] MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom;

[17] School of Medicine, University of Dundee, United Kingdom;

[18] Tan Tock Seng Hospital, Lee Kong Chian School of Medicine Nanyang Technological University, Singapore;

[19] University Clinic in Nephrology and Hypertension, Department of Medical Research, Regional Hospital West Jutland and Aarhus University, Aarhus, Denmark;

[20] University of Wisconsin School of Medicine and Public Health and William S. Middleton Veterans Affairs Hospital, Madison, WI;

关键词: endothelial function;    paricalcitol;    systematic review;    vascular function;    vitamin D;   

DOI  :  10.1161/JAHA.117.008273

来源: DOAJ

【 摘 要 】

BackgroundLow 25‐hydroxyvitamin D levels are associated with an increased risk of cardiovascular events, but the effect of vitamin D supplementation on markers of vascular function associated with major adverse cardiovascular events is unclear. Methods and ResultsWe conducted a systematic review and individual participant meta‐analysis to examine the effect of vitamin D supplementation on flow‐mediated dilatation of the brachial artery, pulse wave velocity, augmentation index, central blood pressure, microvascular function, and reactive hyperemia index. MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.gov were searched until the end of 2016 without language restrictions. Placebo‐controlled randomized trials of at least 4 weeks duration were included. Individual participant data were sought from investigators on included trials. Trial‐level meta‐analysis was performed using random‐effects models; individual participant meta‐analyses used a 2‐stage analytic strategy, examining effects in prespecified subgroups. 31 trials (2751 participants) were included; 29 trials (2641 participants) contributed data to trial‐level meta‐analysis, and 24 trials (2051 participants) contributed to individual‐participant analyses. Vitamin D3 daily dose equivalents ranged from 900 to 5000 IU; duration was 4 weeks to 12 months. Trial‐level meta‐analysis showed no significant effect of supplementation on macrovascular measures (flow‐mediated dilatation, 0.37% [95% confidence interval, −0.23 to 0.97]; carotid‐femoral pulse wave velocity, 0.00 m/s [95% confidence interval, −0.36 to 0.37]); similar results were obtained from individual participant data. Microvascular function showed a modest improvement in trial‐level data only. No consistent benefit was observed in subgroup analyses or between different vitamin D analogues. ConclusionsVitamin D supplementation had no significant effect on most markers of vascular function in this analysis.

【 授权许可】

Unknown