Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman J R, Djafarian K
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Nutr Metab Cardiovasc Dis. 2016 Aug;26(8):663-73. doi: 10.1016/j.numecd.2016.04.011. Epub 2016 Apr 25.
Previous randomized clinical trials (RCTs) of the effects of vitamin D3 supplementation (VD3S) on blood pressure have generated inconsistent results. We evaluated the effect of VD3S on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a meta-analysis.
Literature searches of PubMed, Scopus, Ovid, and Google scholar for publications in English were conducted up to April 2015. RCTs that assessed the effect of VD3S on SBP and DBP were selected.
A total of 30 RCTs with 41 arms including 4744 participants were included. The mean duration of the studies was 5.6 ± 4.0 months, and doses of VD3S varied between 200 and 12,000 IU/day. VD3S had no effect on SBP (-0.68 mmHg, 95%CI: -2.19 to 0.84), and DBP (-0.57 mmHg, 95%CI: -1.36 to 0.22). Subgroup analysis revealed that daily vitamin D3 therapy at a dose of >800 IU/day for <6 months in subjects ≥50 years old reduced both SBP and DBP (p < 0.001). In addition, VD3S showed hypotensive effects in healthy subjects and hypertensive patients, but a hypertensive effect in overweight and obese subjects. However, after excluding overweight and obese subjects, VD3S significantly reduced SBP and DBP. VD3S in combination with calcium supplementation significantly elevated SBP (3.64 mmHg, 95%CI: 3.15-4.13) and DBP (1.71 mmHg, 95%CI: 1.25-2.18). No evidence of publication bias was found. The effects of VD3S on blood pressure depend on dose of supplementation, treatment regimens, trial duration, and population subgroup. Supplementation may be beneficial at daily doses >800 IU/day for <6 months in subjects ≥50 years old.
既往关于补充维生素D3(VD3S)对血压影响的随机临床试验(RCT)结果并不一致。我们通过一项荟萃分析评估了VD3S对收缩压(SBP)和舒张压(DBP)的影响。
截至2015年4月,对PubMed、Scopus、Ovid和谷歌学术进行了英文文献检索。选择了评估VD3S对SBP和DBP影响的RCT。
共纳入30项RCT,包括41个研究组,4744名参与者。研究的平均持续时间为5.6±4.0个月,VD3S的剂量在每日200至12000国际单位之间。VD3S对SBP(-0.68 mmHg,95%CI:-2.19至0.84)和DBP(-0.57 mmHg,95%CI:-1.36至0.22)无影响。亚组分析显示,≥50岁的受试者每日服用剂量>800国际单位的维生素D3<6个月,SBP和DBP均降低(p<0.001)。此外,VD3S在健康受试者和高血压患者中显示出降压作用,但在超重和肥胖受试者中显示出升压作用。然而,排除超重和肥胖受试者后,VD3S显著降低了SBP和DBP。VD3S与补钙联合使用显著升高了SBP(3.64 mmHg,95%CI:3.15 - 4.13)和DBP(1.71 mmHg,95%CI:1.25 - 2.18)。未发现发表偏倚的证据。VD3S对血压的影响取决于补充剂量、治疗方案、试验持续时间和人群亚组。对于≥50岁的受试者,每日剂量>800国际单位且<6个月的补充可能有益。