Department of Air Force Service, Air Force Hospital from Northern Theater of Chinese People's Liberation Army, Shenyang, China.
Department of pediatrics, Shenyang Fourth People's Hospital, Shenyang, China.
Medicine (Baltimore). 2022 Jul 15;101(28):e29507. doi: 10.1097/MD.0000000000029507.
The association of low 25-hydroxyvitamin D level with mortality and rehospitalization remains inconsistent in patients with heart failure. This systematic review and meta-analysis aimed to evaluate the value of blood 25-hydroxyvitamin D level in predicting all-cause mortality and hospitalization in heart failure patients.
Two reviewers independently search the articles indexed in PubMed and Embase databases until November 30, 2021. Only the prospective or retrospective cohort studies evaluating the association of blood 25-hydroxyvitamin D level with all-cause mortality and rehospitalization in heart failure patients were selected. The predictive value of 25-hydroxyvitamin D level was summarized by pooling multivariable adjusted risk estimates for the bottom versus reference top 25-hydroxyvitamin D level.
Seven studies with a total of 5941 patients with heart failure were identified. The pooled adjusted risk ratio (RR) of all-cause mortality was 1.37 (95% confidence interval [CI] 1.13-1.66), with significant heterogeneity (I2 = 70.5%; P = 0.002). However, there was no clear association between low 25-hydroxyvitamin D level and all-cause rehospitalization risk (RR 1.38; 95% CI 0.87-2.19).
Low blood level of 25-hydroxyvitamin D may be an independent risk factor for all-cause mortality in patients with heart failure. Serum 25-hydroxyvitamin D level may provide prognostic information in heart failure patients. Additional randomized controlled trials are required to explore whether treatment of 25-hydroxyvitamin D deficiency by supplementation of vitamin D can improve survival in heart failure patients.
维生素 D 水平低与心力衰竭患者的死亡率和再住院率之间的关联仍不一致。本系统评价和荟萃分析旨在评估血液 25-羟维生素 D 水平预测心力衰竭患者全因死亡率和住院的价值。
两位审查员独立检索 PubMed 和 Embase 数据库中截至 2021 年 11 月 30 日的文章。仅选择评估血液 25-羟维生素 D 水平与心力衰竭患者全因死亡率和再住院率之间关联的前瞻性或回顾性队列研究。通过汇总多变量调整后的最低与参考最高 25-羟维生素 D 水平的风险估计值，总结 25-羟维生素 D 水平的预测价值。
确定了 7 项共纳入 5941 例心力衰竭患者的研究。全因死亡率的合并调整风险比（RR）为 1.37（95%置信区间 [CI] 1.13-1.66），存在显著异质性（I2=70.5%；P=0.002）。然而，低 25-羟维生素 D 水平与全因再住院风险之间没有明确关联（RR 1.38；95% CI 0.87-2.19）。
血液 25-羟维生素 D 水平低可能是心力衰竭患者全因死亡的独立危险因素。血清 25-羟维生素 D 水平可能为心力衰竭患者提供预后信息。需要进一步的随机对照试验来探讨补充维生素 D 治疗 25-羟维生素 D 缺乏是否可以改善心力衰竭患者的生存率。
