Vitamin D and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
Vitamin D and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
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DOI：
10.1210/jc.2011-0398
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发表时间：
2011-07-01
影响因子：
5.8
通讯作者：
Montori, Victor M.
中科院分区：
文献类型：
--
作者：
Elamin, Mohamed B.;Abu Elnour, Nisrin O.;Montori, Victor M.
内容：几项研究发现维生素D水平与高血压，冠状动脉钙化，心脏病之间的关联。目的：本研究的目的是总结证据的影响，维生素D对心血管outcomes.Design和方法：我们搜索电子数据库从成立到2010年8月的随机试验。评审员重复工作，独立提取研究特征、质量和感兴趣的结果。随机效应荟萃分析被用来汇总相对风险（RR）和加权平均差异跨trials.Results：我们发现51个合格的试验与中等质量。维生素D对患者重要结局死亡[RR，0.96; 95%置信区间（CI），0.93，1.00; P = 0.08]、心肌梗死（RR，1.02; 95% CI，0.93，1.13; P = 0.64）和卒中（RR，1.05; 95% CI，0.88，1.25; P = 0.59）。这些分析与最小异质性相关。血脂、血糖、舒张压或收缩压的替代结果无显著变化。后者的分析与显着的异质性，和汇总的估计是微不足道的绝对terms.Conclusions：迄今为止的试验数据无法证明统计学显着降低死亡率和心血管风险与维生素D。现有证据的质量充其量是低到中等。（临床内分泌代谢杂志96：1931-1942，2011）
Context: Several studies found association between vitamin D levels and hypertension, coronary artery calcification, and heart disease.Objective: The aim of this study was to summarize the evidence on the effect of vitamin D on cardiovascular outcomes.Design and Methods: We searched electronic databases from inception through August 2010 for randomized trials. Reviewers working in duplicate and independently extracted study characteristics, quality, and the outcomes of interest. Random-effects meta-analysis was used to pool the relative risks (RR) and the weighted mean differences across trials.Results: We found 51 eligible trials with moderate quality. Vitamin D was associated with nonsignificant effects on the patient-important outcomes of death [RR, 0.96; 95% confidence interval (CI), 0.93, 1.00; P = 0.08], myocardial infarction (RR, 1.02; 95% CI, 0.93, 1.13; P = 0.64), and stroke (RR, 1.05; 95% CI, 0.88, 1.25; P = 0.59). These analyses were associated with minimal heterogeneity. There were no significant changes in the surrogate outcomes of lipid fractions, glucose, or diastolic or systolic blood pressure. The latter analyses were associated with significant heterogeneity, and the pooled estimates were trivial in absolute terms.Conclusions: Trial data available to date are unable to demonstrate a statistically significant reduction in mortality and cardiovascular risk associated with vitamin D. The quality of the available evidence is low to moderate at best. (J Clin Endocrinol Metab 96: 1931-1942, 2011)