Vitamin D Supplementation and Its Impact on Mortality and Cardiovascular Outcomes: Systematic Review and Meta-Analysis of 80 Randomized Clinical Trials

被引:20
作者
Ruiz-Garcia, Antonio [1 ,2 ]
Pallares-Carratala, Vicente [3 ,4 ]
Turegano-Yedro, Miguel [5 ]
Torres, Ferran [6 ]
Sapena, Victor [6 ]
Martin-Gorgojo, Alejandro [7 ]
Martin-Moreno, Jose M. M. [8 ,9 ]
机构
[1] Pinto Univ, Lipids & Cardiovasc Prevent Unit, Hlth Ctr, Madrid 28320, Spain
[2] European Univ Madrid, Dept Med, Madrid 28670, Spain
[3] Castellon Mutual Insurance Union, Hlth Surveillance Unit, Castellon de La Plana 12003, Spain
[4] Univ Jaume 1, Dept Med, Castellon de La Plana 12006, Spain
[5] Aldea Moret Hlth Ctr, Caceres 10195, Spain
[6] Univ Autonoma Barcelona Bellaterra, Med Sch, Biostat Unit, Barcelona 08193, Spain
[7] Madrid City Council, STI Dermatol Dept, Madrid 28014, Spain
[8] Univ Valencia, Dept Prevent Med & Publ Hlth, Valencia 46010, Spain
[9] Clin Univ Hosp, Biomed Res Inst INCLIVA, Valencia 46010, Spain
关键词
vitamin D; all-cause mortality; cardiovascular mortality; myocardial infarction; stroke; heart failure; major adverse cardiovascular events; systematic review; meta-analysis; BONE-MINERAL DENSITY; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; CALCIUM SUPPLEMENTATION; POSTMENOPAUSAL WOMEN; ELDERLY-WOMEN; OLDER-PEOPLE; QUANTITATIVE ULTRASOUND; MYOCARDIAL-INFARCTION; KNEE OSTEOARTHRITIS;
D O I
10.3390/nu15081810
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: The impact of vitamin D supplementation on cardiovascular outcomes and mortality risk reduction remains unclear due to conflicting study findings. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between 1983 and 2022, that reported the effect of vitamin D supplementation in adults versus placebo or no treatment on all-cause mortality (ACM), cardiovascular mortality (CVM), non-cardiovascular mortality (non-CVM), and cardiovascular morbidities. Only studies with a follow-up period longer than one year were included. The primary outcomes were ACM and CVM. Secondary outcomes were non-CVM, myocardial infarction, stroke, heart failure, and major or extended adverse cardiovascular events. Subgroup analyses were performed according to low-, fair- and good-quality RCTs. Results: Eighty RCTs were assessed, including 82,210 participants receiving vitamin D supplementation and 80,921 receiving placebo or no treatment. The participants' mean (SD) age was 66.1 (11.2) years, and 68.6% were female. Vitamin D supplementation was associated with a lower risk of ACM (OR: 0.95 [95%CI 0.91-0.99] p = 0.013), was close to statistical significance for a lower risk of non-CVM (OR: 0.94 [95%CI 0.87-1.00] p = 0.055), and was not statistically associated with a lower risk of any cardiovascular morbi-mortality outcome. Meta-analysis of low-quality RCTs showed no association with cardiovascular or non-cardiovascular morbi-mortality outcomes. Conclusions: The emerging results of our meta-analysis present evidence that vitamin D supplementation appears to decrease the risk of ACM (especially convincing in the fair- and good-quality RCTs), while not showing a decrease in the specific cardiovascular morbidity and mortality risk. Thus, we conclude that further research is warranted in this area, with well-planned and executed studies as the basis for more robust recommendations.
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页数:16
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