Department of Health, CNHS, Zayed University, Dubai P.O. Box 19282, UAE.
Nutrients. 2020 Apr 22;12(4):1163. doi: 10.3390/nu12041163.
Suboptimal vitamin D status is associated with elevated blood pressure (BP) in children and adolescents. Whether vitamin D supplementation reduces BP remains unclear. To systematically review whether vitamin D supplementation reduces BP in children and adolescents, we conducted a literature review according to the PRISMA statement. We included vitamin-D supplementation human interventions studies that reported on BP as an outcome. We searched PUBMED, MEDLINE, CINAHL, EMBASE, the Cochrane Library, and the clinical trials website. We also hand searched the references of the included articles and previous reviews of vitamin D therapy. No language or time restrictions were applied. We extracted data on population characteristics, baseline and endline vitamin D and BP values, and assessed the risk of bias of the included studies. We performed a narrative review of the findings, conducted a meta-analysis when possible, and performed sensitivity analyses to test the robustness of our results. We assessed the overall quality of the evidence produced in the meta-analysis. We included eight studies in our review and five studies in the meta-analysis, none of which included hypertensive only participants. The risk of bias was variable. In non-randomized studies, no effect of vitamin D supplementation was seen on systolic BP (SBP) (mean difference: 0.39 (95% confidence interval (CI): -0.9; 1.68) mmHg; 0.55; I = 0%). Only a significant decrease in diastolic BP (DBP) (mean difference: -1.87 (95% CI: -3.02; -0.72) mmHg; 0.001; I = 0%) was noted. Both analyses had a low quality of evidence. In randomized controlled trials (RCTs), no effect was noted on SBP (mean difference: -2.04 (95% CI: -5.12; 1.04) mmHg; 0.19; I = 71%) nor DBP (mean difference: 0.01 (95% CI: -1.09; 1.12) mmHg; 0.98; I = 0%). The final quality of evidence ranged between low and moderate. Sensitivity analyses did not affect the results. Vitamin D supplementation was found to be ineffective in lowering SBP and DBP in children and adolescents.
维生素 D 状态不佳与儿童和青少年的血压升高有关。维生素 D 补充是否能降低血压尚不清楚。为了系统地综述维生素 D 补充是否能降低儿童和青少年的血压，我们根据 PRISMA 声明进行了文献综述。我们纳入了报告血压为结局的维生素 D 补充的人体干预研究。我们检索了 PUBMED、MEDLINE、CINAHL、EMBASE、Cochrane 图书馆和临床试验网站。我们还手动检索了纳入文章的参考文献和之前的维生素 D 治疗综述。未对语言或时间限制进行应用。我们提取了关于人口特征、基线和终点维生素 D 和血压值的数据，并评估了纳入研究的偏倚风险。我们对研究结果进行了叙述性综述，在可能的情况下进行了荟萃分析，并进行了敏感性分析以检验我们结果的稳健性。我们评估了荟萃分析中产生的证据的总体质量。我们的综述纳入了 8 项研究，荟萃分析纳入了 5 项研究，其中均无仅包括高血压参与者的研究。偏倚风险各不相同。在非随机研究中，维生素 D 补充对收缩压（SBP）无影响（平均差异：0.39（95%置信区间（CI）：-0.9；1.68）mmHg； 0.55；I = 0%）。仅观察到舒张压（DBP）显著下降（平均差异：-1.87（95% CI：-3.02；-0.72）mmHg； 0.001；I = 0%）。这两项分析的证据质量均为低。在随机对照试验（RCT）中，SBP 无影响（平均差异：-2.04（95% CI：-5.12；1.04）mmHg； 0.19；I = 71%），DBP 也无影响（平均差异：0.01（95% CI：-1.09；1.12）mmHg； 0.98；I = 0%）。最终的证据质量在低到中等之间。敏感性分析未影响结果。维生素 D 补充在降低儿童和青少年的 SBP 和 DBP 方面无效。
