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United States Department of Agriculture

Agricultural Research Service

Research Project: DIET AND BIOMARKERS OF CARDIOVASCULAR HEALTH Title: Vitamin D and cardiometabolic outcomes: a systematic review

Authors
item Pittas, Anastassios -
item Chung, Mei -
item Trikalinos, Thomas -
item Mitri, Joanna -
item Brendel, Michael -
item Patel, Kamal -
item Lichtenstein, Alice -
item Lau, Joseph -
item Balk, Ethan -

Submitted to: Annals Of Internal Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: February 1, 2010
Publication Date: March 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.

Last Modified: 12/25/2014
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