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每日补充 4000IU 维生素 D3 三年对晚期心力衰竭患者的心血管风险标志物没有影响:心力衰竭患者维生素 D 死亡率试验。

Daily Supplementation with 4000 IU Vitamin D3 for Three Years Does Not Modify Cardiovascular Risk Markers in Patients with Advanced Heart Failure: The Effect of Vitamin D on Mortality in Heart Failure Trial.

机构信息

Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Bad Oeynhausen, Germany,

Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Bad Oeynhausen, Germany.

出版信息

Ann Nutr Metab. 2019;74(1):62-68. doi: 10.1159/000495662. Epub 2018 Dec 14.

Abstract

BACKGROUND/AIMS: We aimed to investigate the effect of a moderately high vitamin D dose on lipid parameters and biochemical markers of vascular calcification (VC) in patients with established cardiovascular disease.

METHODS

We included in this pre-specified secondary analysis of a randomized controlled trial 161 patients with advanced heart failure and 25-hydroxyvitamin D (25OHD) concentrations < 75 nmol/L (vitamin D group: n = 80; placebo group: n = 81), who received a daily vitamin D3 supplement of 4,000 IU for 3 years. We assessed between-group differences of the lipid parameters total-cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides, and the VC markers fetuin-A and non-phosphorylated undercarboxylated matrix gla protein (MGP) at study termination, with adjustment for baseline values.

RESULTS

Lipid parameters, the percentage of patients with dyslipoproteinemia, and VC markers did not differ significantly between groups at study termination (p values: 0.395-0.939). Likewise, vitamin D achieved no significant treatment effect on these markers in subgroup analyses in patients with 25OHD concentrations < 30 nmol/L, nonusers of lipid-lowering drugs, or diabetic patients (p values: 0.245-0.998).

CONCLUSION

Our data indicate that vitamin D does not improve the lipid profile and does not influence the calcification inhibitors fetuin-A and non-phosphorylated undercarboxylated MGP in patients with advanced heart failure.

摘要

背景/目的:我们旨在研究中等剂量维生素 D 对患有已确诊心血管疾病的患者的脂质参数和血管钙化(VC)生化标志物的影响。

方法

我们将这项预先指定的随机对照试验的二次分析纳入了 161 例患有晚期心力衰竭且 25-羟维生素 D(25OHD)浓度<75nmol/L 的患者(维生素 D 组:n=80;安慰剂组:n=81),这些患者接受了为期 3 年的每日 4000IU 维生素 D3 补充剂治疗。我们评估了研究结束时血脂参数总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯以及 VC 标志物胎球蛋白-A 和非磷酸化未羧化基质 Gla 蛋白(MGP)在组间的差异,同时调整了基线值。

结果

研究结束时,两组之间的脂质参数、血脂异常患者的比例以及 VC 标志物均无显著差异(p 值:0.395-0.939)。同样,维生素 D 在 25OHD 浓度<30nmol/L、未使用降脂药物或糖尿病患者的亚组分析中对这些标志物也没有显著的治疗作用(p 值:0.245-0.998)。

结论

我们的数据表明,维生素 D 不能改善血脂谱,也不能影响晚期心力衰竭患者的钙化抑制剂胎球蛋白-A 和非磷酸化未羧化 MGP。

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