Lee Kyeong Ju, Lee Yu Jeung
Int J Clin Pharmacol Ther. 2016 Apr;54(4):233-42. doi: 10.5414/CP202493.
Previous studies have suggested that vitamin D supplementation may decrease blood pressure in patients with type 2 diabetes, although conflicting results have been reported. The purpose of this meta-analysis was to evaluate the effects of the vitamin D supplementation on blood pressure in patients with type 2 diabetes.
A meta-analysis of published randomized controlled trials was conducted. Eligible studies were identified via a literature search of the MEDLINE (PubMed), EMBASE, and Cochrane Library databases through to May 25, 2015. The endpoint of the analysis was the change in blood pressure due to vitamin D treatment in patients with type 2 diabetes. These changes were calculated as the difference between the baseline and final measurements performed in each study. A fixed-effects model was used to calculate the combined effect estimates; in the presence of heterogeneity, a random-effects model was used.
A total of 15 articles were included in the meta-analysis. All 15 articles, including 1,134 patients with type 2 diabetes, were analyzed for systolic blood pressure (SBP), and 13 articles, including 793 patients, were analyzed for diastolic blood pressure (DBP). The combined-effect estimate of vitamin D intervention on SBP was -0.121 mmHg (95% confidence interval (CI) -0.355 to 0.113, p = 0.311), and considerable heterogeneity was observed between studies (p < 0.001, I(2)= 74.2%). For DBP, the combined effect estimate was -0.160 mmHg (95% CI -0.298 to -0.022, p = 0.023), and no heterigenieity was observed (p = 0.673, I(2) = 0.0%).
This study is the first meta-analysis of the effect of vitamin D supplementation on blood pressure in patients with type 2 diabetes. This meta-analysis demonstrated that vitamin D supplementation may result in a reduction in DBP in patients with type 2 diabetes. However, additional studies with large sample sizes and longer durations are needed to establish a relationship between vitamin D and blood pressure in patients with type 2 diabetes.
既往研究表明,补充维生素D可能会降低2型糖尿病患者的血压,尽管也有相互矛盾的结果报道。本荟萃分析的目的是评估补充维生素D对2型糖尿病患者血压的影响。
对已发表的随机对照试验进行荟萃分析。通过检索MEDLINE(PubMed)、EMBASE和Cochrane图书馆数据库,直至2015年5月25日,确定符合条件的研究。分析的终点是2型糖尿病患者因维生素D治疗导致的血压变化。这些变化计算为每项研究中基线测量值与最终测量值之间的差值。采用固定效应模型计算合并效应估计值;若存在异质性,则采用随机效应模型。
荟萃分析共纳入15篇文章。对所有15篇文章(包括1134例2型糖尿病患者)进行了收缩压(SBP)分析,对13篇文章(包括793例患者)进行了舒张压(DBP)分析。维生素D干预对SBP的合并效应估计值为-0.121 mmHg(95%置信区间(CI)-0.355至0.113;p = 0.311),各研究间观察到显著异质性(p < 0.001,I² = 74.2%)。对于DBP,合并效应估计值为-0.160 mmHg(95% CI -0.298至-0.022;p = 0.023),未观察到异质性(p = 0.673,I² = 0.0%)。
本研究是首次对补充维生素D对2型糖尿病患者血压影响的荟萃分析。该荟萃分析表明,补充维生素D可能会使2型糖尿病患者的DBP降低。然而,需要更多大样本量和更长时间的研究来确定2型糖尿病患者中维生素D与血压之间的关系。