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维生素 D 补充对心力衰竭炎症标志物的影响:系统评价和随机对照试验的荟萃分析。

Effects of vitamin D supplementation on inflammatory markers in heart failure: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Bone and Muscle Health Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

出版信息

Sci Rep. 2018 Jan 18;8(1):1169. doi: 10.1038/s41598-018-19708-0.

Abstract

Vitamin D is reported to have anti-inflammatory properties; however the effects of vitamin D supplementation on inflammation in patients with heart failure (HF) have not been established. We performed a systematic review and meta-analysis examining effects of vitamin D supplementation on inflammatory markers in patients with HF. MEDLINE, CINAHL, EMBASE, All EBM, and Clinical Trials registries were systematically searched for RCTs from inception to 25 January 2017. Two independent reviewers screened all full text articles (no date or language limits) for RCTs reporting effects of vitamin D supplementation (any form, route, duration, and co-supplementation) compared with placebo or usual care on inflammatory markers in patients with heart failure. Two reviewers assessed risk of bias and quality using the grading of recommendations, assessment, development, and evaluation approach. Seven studies met inclusion criteria and six had data available for pooling (n = 1012). In meta-analyses, vitamin D-supplemented groups had lower concentrations of tumor necrosis factor-alpha (TNF-α) at follow-up compared with controls (n = 380; p = 0.04). There were no differences in C-reactive protein (n = 231), interleukin (IL)-10 (n = 247) or IL-6 (n = 154) between vitamin D and control groups (all p > 0.05). Our findings suggest that vitamin D supplementation may have specific, but modest effects on inflammatory markers in HF.

摘要

维生素 D 具有抗炎特性;然而,维生素 D 补充剂对心力衰竭(HF)患者炎症的影响尚未确定。我们进行了一项系统评价和荟萃分析,研究了维生素 D 补充剂对 HF 患者炎症标志物的影响。从建库到 2017 年 1 月 25 日,我们系统地检索了 MEDLINE、CINAHL、EMBASE、All EBM 和临床试验登记处的 RCTs。两名独立的审查员筛选了所有全文文章(无日期或语言限制),以评估报告维生素 D 补充剂(任何形式、途径、持续时间和联合补充)与安慰剂或常规护理对心力衰竭患者炎症标志物影响的 RCTs。两名审查员使用推荐评估、制定与评价分级法评估偏倚风险和质量。有 7 项研究符合纳入标准,其中 6 项有可用数据进行汇总(n=1012)。在荟萃分析中,与对照组相比,维生素 D 补充组在随访时肿瘤坏死因子-α(TNF-α)浓度较低(n=380;p=0.04)。维生素 D 组和对照组在 C 反应蛋白(n=231)、白细胞介素(IL)-10(n=247)或 IL-6(n=154)方面均无差异(所有 p>0.05)。我们的研究结果表明,维生素 D 补充剂可能对 HF 患者的炎症标志物有特定但适度的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/702c/5773527/889825f9647e/41598_2018_19708_Fig1_HTML.jpg

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