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United States Department of Agriculture

Agricultural Research Service

Research Project: DIET AND BIOMARKERS OF CARDIOVASCULAR HEALTH

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Vitamin D and cardiometabolic outcomes: a systematic review)

Author
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: 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.

Last Modified: 8/24/2016
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