Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials: A Meta-analysis
Barbarawi M, Kheiri B, Zayed Y, Barbarawi O, Dhillon H, Swaid B, Yelangi A, Sundus S, Bachuwa G, Alkotob ML, Manson JE
JAMA cardiology · 295 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Cancer Institute
- Gobierno
- NCI NIH HHS
- Subvenciones
- National Cancer Institute (R01CA138962)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2019-06-19 · JAMA Cardiol · vol. 4 · número 8 · pág. 765
- Editorial
- American Medical Association
- Citado
- 376 citas · más que el 100% de estudios similares · 29.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 50 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Nutritional Studies and Diet · Nutrition and Health Studies
- Palabras clave
- vitamin D supplementation, cardiovascular disease, major adverse cardiovascular events, myocardial infarction, stroke, cardiovascular mortality, all-cause mortality, vitamin D deficiency, long-term supplementation, randomized controlled trials, meta-analysis of trials, causal inference, confounding, vitamin D receptor agonists
- MeSH
- humans, cardiovascular diseases, vitamin d, risk assessment, dietary supplements, randomized controlled trials as topic
11 autores
- Mahmoud Barbarawi🇺🇸 · autor de correspondenciaHurley Medical Center; Michigan State University
- Babikir Kheiri🇺🇸Hurley Medical Center; Michigan State University
- Yazan Zayed🇺🇸Hurley Medical Center; Michigan State University
- Owais Barbarawi🇯🇴Mutah University
- Harsukh Dhillon🇺🇸Hurley Medical Center; Michigan State University
- Bakr Swaid🇺🇸Hurley Medical Center; Michigan State University
- Anitha Yelangi🇺🇸Hurley Medical Center; Michigan State University
- Saira Sundus🇺🇸Hurley Medical Center; Michigan State University
- Ghassan I. Bachuwa🇺🇸Hurley Medical Center; Michigan State University
- Mohammad Luay Alkotob🇺🇸Hurley Medical Center; Michigan State University
- JoAnn E. Manson🇺🇸Brigham and Women's Hospital; Harvard University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Observational studies have reported an association between low serum vitamin D levels and elevated risk of cardiovascular disease (CVD) events, but such studies cannot prove causation because of possible unmeasured confounding.
Objective
We conducted a meta-analysis of randomized clinical trials that tested the association of vitamin D supplementation with reduced CVD events and all-cause mortality.
Data sources
Literature search through PubMed, the Cochrane Library, and Embase was completed by 2 reviewers from each database's inception to December 15, 2018.
Study selection
Inclusion criteria were randomized clinical trials that reported the effect of long-term (≥1 year) vitamin D supplementation on CVD events and all-cause mortality. Studies that did not include cardiovascular outcomes were excluded.
Data extraction and synthesis
Data were abstracted independently by 2 authors. Random-effects models were used to report the risk ratios (RRs) and 95% CIs.
Main outcomes and measures
Major adverse cardiovascular events was the primary outcome, and rates of myocardial infarction, stroke or cerebrovascular accident, CVD mortality, and all-cause mortality were the secondary end points.
Results
Twenty-one randomized clinical trials were included (including 83 291 patients, of whom 41 669 received vitamin D and 41 622 received placebos). The mean (SD) age of trial participants was 65.8 (8.4) years; 61 943 (74.4%) were female. Only 4 trials had prespecified CVD as a primary end point. Vitamin D supplementation compared with placebo was not associated with reduced major adverse cardiovascular events (RR, 1.00 [95% CI, 0.95-1.06]; P = .85) nor the secondary end points of myocardial infarction (RR, 1.00 [95% CI, 0.93-1.08]; P = .92), stroke (RR, 1.06 [95% CI, 0.98-1.15]; P = .16), CVD mortality (RR, 0.98 [95% CI, 0.90-1.07]; P = .68), or all-cause mortality (RR, 0.97 [95% CI, 0.93-1.02]; P = .23). Results were generally consistent by sex, baseline 25-hydroxyvitamin D level, vitamin D dosage, formulation (daily vs bolus dosing), and presence or absence of concurrent calcium administration.
Conclusions and relevance
In this updated meta-analysis, vitamin D supplementation was not associated with reduced major adverse cardiovascular events, individual CVD end points (myocardial infarction, stroke, CVD mortality), or all-cause mortality. The findings suggest that vitamin D supplementation does not confer cardiovascular protection and is not indicated for this purpose.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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