TY - JOUR
T1 - Effect of Vitamin D Supplementation on Markers of Vascular Function
T2 - A Systematic Review and Individual Participant Meta-Analysis
AU - Beveridge, Louise A.
AU - Khan, Faisel
AU - Struthers, Allan D.
AU - Armitage, Jane
AU - Barchetta, Ilaria
AU - Bressendorff, Iain
AU - Cavallo, Maria Gisella
AU - Clarke, Robert
AU - Dalan, Rinkoo
AU - Dreyer, Gavin
AU - Gepner, Adam D.
AU - Forouhi, Nita G.
AU - Harris, Ryan A.
AU - Hitman, Graham A.
AU - Larsen, Thomas
AU - Khadgawat, Rajesh
AU - Marckmann, Peter
AU - Mose, Frank H.
AU - Pilz, Stefan
AU - Scholze, Alexandra
AU - Shargorodsky, Marina
AU - Sokol, Seth I.
AU - Stricker, Hans
AU - Zoccali, Carmine
AU - Witham, Miles D.
PY - 2018/5/30
Y1 - 2018/5/30
N2 - Background Low 25-hydroxyvitamin D levels are associated with an increased risk of cardiovascular events, but the effect of vitamin D supplementation on markers of vascular function associated with major adverse cardiovascular events is unclear.Methods and Results We conducted a systematic review and individual participant meta-analysis to examine the effect of vitamin D supplementation on flow-mediated dilatation of the brachial artery, pulse wave velocity, augmentation index, central blood pressure, microvascular function, and reactive hyperemia index. MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.gov were searched until the end of 2016 without language restrictions. Placebo-controlled randomized trials of at least 4~weeks duration were included. Individual participant data were sought from investigators on included trials. Trial-level meta-analysis was performed using random-effects models; individual participant meta-analyses used a 2-stage analytic strategy, examining effects in prespecified subgroups. 31 trials (2751 participants) were included; 29 trials (2641 participants) contributed data to trial-level meta-analysis, and 24 trials (2051 participants) contributed to individual-participant analyses. Vitamin D3 daily dose equivalents ranged from 900 to 5000~IU; duration was 4~weeks to 12~months. Trial-level meta-analysis showed no significant effect of supplementation on macrovascular measures (flow-mediated dilatation, 0.37% [95% confidence interval, -0.23 to 0.97]; carotid-femoral pulse wave velocity, 0.00~m/s [95% confidence interval, -0.36 to 0.37]); similar results were obtained from individual participant data. Microvascular function showed a modest improvement in trial-level data only. No consistent benefit was observed in subgroup analyses or between different vitamin D analogues.Conclusions Vitamin D supplementation had no significant effect on most markers of vascular function in this analysis.
AB - Background Low 25-hydroxyvitamin D levels are associated with an increased risk of cardiovascular events, but the effect of vitamin D supplementation on markers of vascular function associated with major adverse cardiovascular events is unclear.Methods and Results We conducted a systematic review and individual participant meta-analysis to examine the effect of vitamin D supplementation on flow-mediated dilatation of the brachial artery, pulse wave velocity, augmentation index, central blood pressure, microvascular function, and reactive hyperemia index. MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.gov were searched until the end of 2016 without language restrictions. Placebo-controlled randomized trials of at least 4~weeks duration were included. Individual participant data were sought from investigators on included trials. Trial-level meta-analysis was performed using random-effects models; individual participant meta-analyses used a 2-stage analytic strategy, examining effects in prespecified subgroups. 31 trials (2751 participants) were included; 29 trials (2641 participants) contributed data to trial-level meta-analysis, and 24 trials (2051 participants) contributed to individual-participant analyses. Vitamin D3 daily dose equivalents ranged from 900 to 5000~IU; duration was 4~weeks to 12~months. Trial-level meta-analysis showed no significant effect of supplementation on macrovascular measures (flow-mediated dilatation, 0.37% [95% confidence interval, -0.23 to 0.97]; carotid-femoral pulse wave velocity, 0.00~m/s [95% confidence interval, -0.36 to 0.37]); similar results were obtained from individual participant data. Microvascular function showed a modest improvement in trial-level data only. No consistent benefit was observed in subgroup analyses or between different vitamin D analogues.Conclusions Vitamin D supplementation had no significant effect on most markers of vascular function in this analysis.
KW - Endothelial function
KW - Paricalcitol
KW - Systematic review
KW - Vascular function
KW - Vitamin D
KW - Vascular Stiffness/drug effects
KW - Humans
KW - Middle Aged
KW - Male
KW - Treatment Outcome
KW - Dietary Supplements/adverse effects
KW - Young Adult
KW - Vitamin D/adverse effects
KW - Endothelium, Vascular/drug effects
KW - Vitamin D Deficiency/diagnosis
KW - Adolescent
KW - Adult
KW - Biomarkers/blood
KW - Female
KW - Aged
KW - Hemodynamics/drug effects
KW - Cardiovascular Diseases/diagnosis
U2 - 10.1161/JAHA.117.008273
DO - 10.1161/JAHA.117.008273
M3 - Journal article
C2 - 29848497
VL - 7
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 11
M1 - e008273
ER -