Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Heart. 2012 Apr;98(8):609-14. doi: 10.1136/heartjnl-2011-301356. Epub 2012 Feb 28.
Vitamin D is a fat-soluble secosteroid produced in the skin as a result of sunlight exposure, and its circulating levels are reduced in a wide variety of chronic illnesses and obesity. Observational studies clearly demonstrate a higher incidence of cardiovascular events in individuals with low circulating 25-hydroxyvitamin D [25(OH)D]. This relationship can potentially be explained by confounding, because individuals with low 25(OH)D are generally older, frailer, heavier, and have more comorbidities and higher estimated cardiovascular risk than individuals with higher 25(OH)D. The vitamin D receptor appears to be widely distributed, including in cardiovascular tissue, although this has recently been contested. Despite these epidemiological and laboratory findings, meta-analyses of clinical trials have not shown evidence of beneficial effects of vitamin D supplementation on cardiovascular endpoints. Trials are underway to assess these possibilities further. At present, there is insufficient evidence to support vitamin D supplementation for improving cardiovascular outcomes.
维生素 D 是一种脂溶性甾体化合物，在皮肤中产生，是阳光照射的结果，其循环水平在各种慢性疾病和肥胖症中降低。观察性研究清楚地表明，循环 25-羟维生素 D [25(OH)D]水平低的个体心血管事件的发生率更高。这种关系可能可以通过混杂因素来解释，因为与循环 25(OH)D 水平较高的个体相比，25(OH)D 水平低的个体通常年龄更大、身体更脆弱、体重更重，并且合并症更多，心血管风险更高。维生素 D 受体似乎分布广泛，包括心血管组织，尽管这一点最近受到质疑。尽管有这些流行病学和实验室发现，但对临床试验的荟萃分析并未显示维生素 D 补充对心血管终点有有益影响的证据。正在进行临床试验以进一步评估这些可能性。目前，尚无足够的证据支持维生素 D 补充以改善心血管结局。
