Skip to main content
ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #254935
Title: Vitamin D and cardiometabolic outcomes: a systematic review

Author
item PITTAS, ANASTASSIOS - Tufts - New England Medical Center
item CHUNG, MEI - Friedman School Of Nutrition
item TRIKALINOS, THOMAS - Tufts - New England Medical Center
item MITRI, JOANNA - Tufts - New England Medical Center
item BRENDEL, MICHAEL - Tufts - New England Medical Center
item PATEL, KAMAL - Friedman School Of Nutrition
item LICHTENSTEIN, ALICE - Friedman School Of Nutrition
item LAU, JOSEPH - Friedman School Of Nutrition
item BALK, ETHAN - Tufts - New England Medical Center

Submitted to: Annals of Internal Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/1/2010
Publication Date: 3/2/2010
Citation: Pittas, A.G., Chung, M., Trikalinos, T., Mitri, J., Brendel, M., Patel, K., Lichtenstein, A.H., Lau, J., Balk, E. 2010. Vitamin D and cardiometabolic outcomes: a systematic review. Annals Of Internal Medicine. 152(5):307-314.

Interpretive Summary: Cardiometaboic syndrome is characterized one or more of the following; high blood pressure, low HDL cholesterol concentration, high byglyceride concentration, high waist circumference and high glucose concentrations. There is some evidence that vitamin D intakes may modify risk of cardiometabolic outcomes (type 2 diabetes, hypertension, or cardiovascular disease). We systematically reviewed the published literature of vitamin D status and supplementation on cardiometabolic outcomes. Identified were 12 observational studies (13 cohorts) and 13 trials. Three of 6 analyses (from 4 different cohorts) reported a lower risk of incident diabetes in the highest versus lowest vitamin D status groups. Four trials found no effect of vitamin D supplementation on glycemia or incident diabetes. Meta-analysis of 3 cohorts found low 25-hydroxyvitamin D concentration was associated with incident hypertension. In meta-analyses of 8 trials, vitamin D supplementation resulted in a non-significant reduction in systolic blood pressure and had no significant effect on diastolic blood pressure. Low plasma 25-hydroxyvitamin D (a marker for vitamin D status in blood) concentration was associated with incident cardiovascular disease in 4 of 6 analyses (5 cohorts). Two trials found no significant effect of vitamin D supplementation on cardiovascular outcomes. From this work we conclude that the association between vitamin D status and cardiometabolic outcomes remains uncertain. Supplementation trials have not identified a clinically significant benefit of vitamin D on cardiometabolic outcomes.

Technical Abstract: Background: Vitamin D may modify risk of cardiometabolic outcomes (type 2 diabetes, hypertension, or cardiovascular disease). Purpose: Examine the association of vitamin D status and the effect of vitamin D supplementation on cardiometabolic outcomes. Data Sources: English-language studies in MEDLINE and the Cochrane Clinical Trials Register through April 2009. Study Selection: Longitudinal cohort studies reporting associations of vitamin D status and randomized trials of vitamin D supplementation on cardiometabolic outcomes were included. Data Extraction: Study characteristics and results were extracted. Study quality was assessed. Differences were resolved by consensus. Data Synthesis: Twelve observational studies (13 cohorts) and 13 trials were eligible. Three of 6 analyses (from 4 different cohorts) reported a lower risk of incident diabetes in the highest versus lowest vitamin D status groups. Four trials found no effect of vitamin D supplementation on glycemia or incident diabetes. Meta-analysis of 3 cohorts found low 25-hydroxyvitamin D concentration was associated with incident hypertension (relative risk 1.8; 95% confidence interval [CI] 1.3, 2.4). In meta-analyses of 8 trials, vitamin D supplementation resulted in a nonsignificant reduction in systolic blood pressure (weighted mean difference [WMD] 1.9; 95% CI 4.6, 0.8 mm Hg) and had no effect on diastolic blood pressure (WMD -0.2; 95% CI -0.9, 0.6 mm Hg). Low 25-hydroxyvitamin D concentration was associated with incident cardiovascular disease in 4 of 6 analyses (5 cohorts). Two trials found no effect of vitamin D supplementation on cardiovascular outcomes. Limitations: Studies included primarily whites. Observational studies were heterogeneous. Most trials reported post hoc analyses. Conclusions: The association between vitamin D status and cardiometabolic outcomes remains uncertain. Trials showed no clinically significant effect of vitamin D supplementation at doses given.