Vitamin D Supplementation and Its Impact on Mortality and Cardiovascular Outcomes : Systematic Review and Meta-Analysis of 80 Randomized Clinical Trials
Ruiz-García, Antonio (Centro de Salud Universitario Pinto)
Pallares-Carratala, Vicente (Universitat Jaume I)
Turégano-Yedro, Miguel (Centro de Salud Aldea Moret)
Torres, Ferran (Universitat Autònoma de Barcelona)
Sapena, Victor (Universitat Autònoma de Barcelona)
Martin-Gorgojo, Alejandro (Ayuntamiento de Madrid)
Martin-Moreno, Jose M. (Hospital Clínic Universitari (València))

Data:	2023
Resum:	The impact of vitamin D supplementation on cardiovascular outcomes and mortality risk reduction remains unclear due to conflicting study findings. 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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Vitamin D ; All-cause mortality ; Cardiovascular mortality ; Heart failure ; Major adverse cardiovascular events ; Meta-analysis ; Myocardial infarction ; Stroke ; Systematic review
Publicat a:	Nutrients, Vol. 15 (april 2023) , ISSN 2072-6643

DOI: 10.3390/nu15081810
PMID: 37111028

16 p, 2.0 MB

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