Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial
Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial
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DOI：
10.1093/ajcn/83.4.754
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发表时间：
2006-04-01
影响因子：
7.1
通讯作者：
Koerfer, R
中科院分区：
文献类型：
--
作者：
Schleithoff, SS;Zittermann, A;Koerfer, R
背景：促炎细胞因子的循环浓度升高可能有助于充血性心力衰竭（CHF）的发病机制。体外研究表明，维生素D抑制促炎细胞因子，增加抗炎细胞因子。目的：我们评估了补充维生素D对CHF患者生存率和不同生化变量的影响。设计：123例患者随机接受50 μ g维生素D-3/d +500 mg Ca/d [D（+）组]或安慰剂+500 mg Ca/d [D（-）组] 9个月在基线和9个月后评估生化变量。生存率计算的随访期为15 mo.Results：93例患者完成了研究。观察到对25-羟基维生素D（P = 0.001）、甲状旁腺激素（P = 0.007）、肿瘤坏死因子α（P = 0.006）和白细胞介素10（P = 0.042）的代谢转化血清浓度的显著治疗效应。25-D（+）组的羟维生素D增加了26.8 ng/mL，但D（-）组仅增加了3.6 ng/mL。与基线相比，9个月后D（+）组的甲状旁腺激素显著降低，而β细胞因子白细胞介素10显著升高。促炎细胞因子肿瘤坏死因子α在D（-）组中增加，但在D（+）组中保持不变。在随访期间，研究组之间的生存率没有显着差异。结论：维生素D-3降低了CHF患者的炎症环境，并可能作为一种新的治疗药物，为未来的疾病治疗。我们的数据提供了证据，参与了受损的维生素D-甲状旁腺激素轴在CHF的进展。
Background: Elevated circulating concentrations of proinflammatory cytokines may contribute to the pathogenesis of congestive heart failure (CHF). In vitro studies suggest that vitamin D suppresses proinflammatory cytokines and increases anti inflammatory cytokines.Objective: We evaluated the effect of vitamin-D supplementation on the survival rate and different biochemical variables in patients with CHF.Design: One hundred twenty-three patients randomly received either 50 mu g vitamin D-3/d plus 500 mg Ca/d [D(+) group] or placebo plus 500 mg Ca/d [D(-) group] for 9 mo. Biochemical variables were assessed at baseline and after 9 mo. The survival rate was calculated for a follow-up period of 15 mo.Results: Ninety-three patients completed the study. Significant treatment effects were observed on logarithmic-transformed serum concentrations of 25-hydroxyvitamin D (P = 0.001), parathyroid hormone (P = 0.007), tumor necrosis factor alpha (P = 0.006), and interleukin 10 (P = 0.042). 25-Hydroxyvitamin D increased by 26.8 ng/mL in the D(+) group but increased only by 3.6 ng/mL in the D(-) group. Compared with baseline, parathyroid hormone was significantly lower and the antiinflammatory cytokine interleukin 10 was significantly higher in the D(+) group after 9 mo. The proinflammatory cytokine tumor necrosis factor alpha increased in the D(-) group but remained constant in the D(+) group. The survival rate did not differ significantly between the study groups during the follow-up period.Conclusions: Vitamin D-3 reduces the inflammatory milieu in CHF patients and might serve as a new antiinflammatory agent for the future treatment of the disease. Our data provide evidence for the involvement of an impaired vitamin D-parathyroid hormone axis in the progression of CHF.