Stojanović Marko, Radenković Miroslav
Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Cardiovasc Ther. 2015 Jun;33(3):145-54. doi: 10.1111/1755-5922.12122.
The possible effect of vitamin D administration in humans on endothelial dysfunction (ED) still remains undetermined. The current meta-analysis was performed to evaluate if vitamin D could improve ED.
Randomized, double-blind, and placebo-controlled clinical trials were identified by systematic search of the PubMed, the Cochrane Library, the Web of Science and the Scopus data bases, as well as different reviews and clinical trials articles. A random effects model was used to calculate the pooled overall effect on flow-mediated dilation (FMD) linked to the vitamin D administration. Meta-regression and subgroup analyses were performed to evaluate the impact of study characteristics on the effect of vitamin D administration on FMD.
A total of eight studies with nine relevant study arms were identified. The obtained results of pooled analysis showed that vitamin D administration did not improve FMD (eight studies, 529 subjects; weighted mean difference (WMD): 0.96%, 95% CI: -1.24% to 2.06%; P = 0.09). This was probably due to significant heterogeneity in between included trials (I(2) = 84%, P < 0.00001). On the other hand, subgroup analysis demonstrated that vitamin D improved FMD in trials that lasted <16 weeks; if systolic blood pressure (SBP) was higher than 140 mmHg and in trials where diastolic blood pressure (DBP) was <80 mmHg.
Although the current evidence clearly demonstrates that in certain conditions vitamin D can improve ED, a larger number of clinical trials are needed to confirm this assumption to confirm or reject the final statement on this topic.
维生素D对人体内皮功能障碍(ED)的潜在影响仍未确定。进行本次荟萃分析以评估维生素D是否能改善内皮功能障碍。
通过系统检索PubMed、Cochrane图书馆、科学网和Scopus数据库以及不同的综述和临床试验文章,确定随机、双盲和安慰剂对照临床试验。采用随机效应模型计算与维生素D给药相关的血流介导的血管舒张(FMD)的合并总体效应。进行Meta回归和亚组分析,以评估研究特征对维生素D给药对FMD影响的作用。
共确定了八项研究,包含九个相关研究组。汇总分析结果显示,给予维生素D并未改善FMD(八项研究,529名受试者;加权平均差(WMD):0.96%,95%置信区间:-1.24%至2.06%;P = 0.09)。这可能是由于纳入试验之间存在显著异质性(I² = 84%,P < 0.00001)。另一方面,亚组分析表明,在持续时间<16周的试验中、收缩压(SBP)高于140 mmHg的试验中以及舒张压(DBP)<80 mmHg的试验中,维生素D可改善FMD。
尽管目前的证据清楚地表明,在某些情况下维生素D可以改善内皮功能障碍,但仍需要更多的临床试验来证实这一假设,以确认或否定关于该主题的最终结论。