Randomized supplementation of 4000 IU vitamin D3 daily vs placebo on the prevalence of anemia in advanced heart failure: the EVITA trial

Nutrition Journal

Research

J. F. Gummert¹  A. Zittermann¹  S. Prokop¹  U. Fuchs¹  J. B. Ernst¹  J. Börgermann¹  H. K. Berthold²  S. Pilz³  J. Dreier⁴  J. Kuhn⁴  C. Knabbe⁴  I. Gouni-Berthold⁵ 

[1] Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstraße 11, D-32545, Bad Oeynhausen, Germany;Department of Internal Medicine and Geriatrics, Bielefeld Evangelical Hospital (EvKB), Bielefeld, Germany;Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Institute for Laboratory and Transfusion Medicine, Heart- and Diabetes Center NRW, Ruhr University Bochum, Bochum, Bad Oeynhausen, Germany;Polyclinic for Endocrinology, Diabetes and Preventive Medicine (PEDP), University of Cologne, Cologne, Germany;

关键词: Vitamin D supplementation;    Hemoglobin;    Anemia;    25-Hydroxyvitamin D;    1,25-Dihydroxyvitamin D;    Chronic heart failure;   

DOI  :  10.1186/s12937-017-0270-5

 received in 2017-05-29, accepted in 2017-08-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLow 25-hydroxyvitamin D (25OHD) levels (< 75 nmol/l) are inversely associated with anemia prevalence. Since anemia and low 25OHD levels are common in patients with heart failure (HF), we aimed to investigate whether vitamin D supplementation can reduce anemia prevalence in advanced HF.MethodsEVITA (Effect of Vitamin D on Mortality in Heart Failure) is a randomized, placebo-controlled clinical trial in patients with initial 25OHD levels < 75 nmol/l. Participants received either 4000 IU vitamin D3 daily or a matching placebo for 36 months. A total of 172 patients (vitamin D group: n = 85; placebo group: n = 87) were investigated in this pre-specified secondary data analysis. Hemoglobin (Hb) and other hematological parameters were measured at baseline and study termination. Assessment of between-group differences in anemia prevalence and Hb concentrations was performed at study termination, while adjusting for baseline differences.ResultsIn the vitamin D and placebo group, baseline proportions of patients with anemia (Hb < 12.0 g/dL in females and < 13.0 g/dL in males) were 17.2% and 10.6%, respectively (P = 0.19). At study termination, the proportion of patients with anemia in the vitamin D and placebo groups was 32.2% and 31.8%, respectively (P > 0.99). There was no between-group difference in change in the Hb concentrations (− 0.04 g/dL [95%CI:-0.53 to 0.45 g/dL]; P = 0.87). Results regarding anemia risk and Hb concentrations were similar in the subgroup of patients with chronic kidney disease (vitamin D group: n = 26; placebo group: n = 23). Moreover, results did not differ substantially when data analysis was restricted to patients with deficient baseline 25OHD levels.ConclusionsA daily vitamin D supplement of 4000 IU did not reduce anemia prevalence in patients with advanced HF. Data challenge the clinical relevance of vitamin D supplementation to increase Hb levels.Trial registrationThe study was registered at EudraCT (No. 2010–020793-42) and clinicaltrials.gov (NCT01326650).

【 授权许可】

CC BY   
© The Author(s). 2017