Vitamin D, Calcium, and Cardiovascular Disease: A"D"vantageous or "D"etrimental? An Era of Uncertainty.
Vitamin D, Calcium, and Cardiovascular Disease: A"D"vantageous or "D"etrimental? An Era of Uncertainty.
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DOI：
10.1007/s11883-017-0637-2
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发表时间：
2017-01
影响因子：
5.8
通讯作者：
Michos ED
中科院分区：
文献类型：
--
作者：
Chin K;Appel LJ;Michos ED
虽然维生素 D 在调节钙稳态方面的功能已得到充分证实，但人们对其在预防多种慢性疾病（包括心血管疾病 (CVD)）方面的作用越来越感兴趣。越来越多的流行病学证据表明，维生素 D 缺乏与 CVD 风险增加有关。然而，之前的维生素 D 补充剂试验在心血管健康方面的结果好坏参半，而且正在进行的大规模随机对照试验的结果尚未公布。使问题进一步复杂化的是，一些（但不是全部）研究表明，钙补充剂（通常与维生素 D 同时服用）与 CVD 风险增加有关。因此，目前尚不清楚维生素 D 补充剂（尤其是维生素 D 缺乏者）是否有助于预防 CVD 的发生。此外，对于构成“充足”的 25-羟基维生素 D 水平阈值，各组织指南尚未达成统一共识。这篇综述将提供有关维生素 D 和钙补充剂对 CVD 临床结果影响的最新证据的更新，总结正在进行的维生素 D 试验，并讨论当前有关维生素 D 缺乏症筛查和补充的但截然不同的建议。
While the function of vitamin D in regulating calcium homeostasis is well established, there has been growing interest in its role in the prevention of numerous chronic diseases, including cardiovascular disease (CVD). There is mounting epidemiological evidence suggesting that vitamin D deficiency is linked to increased CVD risk. However, the results of previous vitamin D supplementation trials have yielded mixed results in regards to cardiovascular health, and the results of on-going large-scale randomized controlled trials are not yet available. Further complicating the issue, calcium supplementation, which is often prescribed concurrently with vitamin D, has been associated with increased CVD risk in some (but not all) studies. Thus, it is currently unclear whether vitamin D supplements, particularly for those that are deficient, can help prevent the development of CVD. In addition, there has not been uniform consensus regarding the threshold of 25-hydroxyvitamin D levels that constitutes “sufficiency” across organizational guidelines. This review will provide an update on the most recent evidence regarding the effects of vitamin D and calcium supplements on CVD clinical outcomes, summarize ongoing vitamin D trials, and discuss the current but remarkably disparate recommendations regarding vitamin D deficiency screening and supplementation.