M. Rasouli, Shahram Darvishzadehdaledari, Zeynab Alizadeh, Ghobad Moradi, Fatemeh Gholami, Ako Mahmoudian
{"title":"29 项随机临床试验中超过 13.4 万人的维生素 D 补充与心血管疾病风险,以及 30 项前瞻性队列研究中超过 15.7 万人的维生素 D 补充与心血管疾病风险:最新的系统回顾和元分析","authors":"M. Rasouli, Shahram Darvishzadehdaledari, Zeynab Alizadeh, Ghobad Moradi, Fatemeh Gholami, Ako Mahmoudian","doi":"10.34172/jrhs.2023.129","DOIUrl":null,"url":null,"abstract":"Background: According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials. Study Design: A systematic review. Methods: MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel’s random-effects model. Then, Stata version 14 was used for statistical analysis. Results: In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; P=0.77; I 2=0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; P=0.72; I2=0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61). Conclusion: According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. According to the results of clinical trial studies carrying higher levels of scientific evidence, it can be concluded that vitamin D supplementation does not exert a significant effect on the incidence, mortality, and reduction of CVDs.","PeriodicalId":17164,"journal":{"name":"Journal of research in health sciences","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 134000 Individuals in 29 Randomized Clinical Trials and 157000 Individuals in 30 Prospective Cohort Studies: An Updated Systematic Review and Meta-analysis\",\"authors\":\"M. Rasouli, Shahram Darvishzadehdaledari, Zeynab Alizadeh, Ghobad Moradi, Fatemeh Gholami, Ako Mahmoudian\",\"doi\":\"10.34172/jrhs.2023.129\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials. Study Design: A systematic review. Methods: MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel’s random-effects model. Then, Stata version 14 was used for statistical analysis. Results: In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; P=0.77; I 2=0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; P=0.72; I2=0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61). Conclusion: According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. 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引用次数: 0
摘要
背景:根据观察性研究和临床试验的结果,评估维生素 D 补充剂对心血管疾病(CVDs)的影响仍然存在相互矛盾的结果。本系统综述旨在通过队列研究和临床试验评估维生素 D 补充剂对心血管疾病的影响。研究设计:系统综述。研究方法:MEDLINE/PubMed由两名审稿人独立审查 MEDLINE/PubMed、Science Direct、Embase 和 Cochrane Library 数据库,直至 2022 年。根据 Mantel Haenszel 随机效应模型,研究效果为风险比(RR)和 95% 置信区间(CI)。然后使用 Stata 14 版本进行统计分析。结果在临床试验研究中,维生素 D 摄入组与安慰剂组的心血管疾病发病率无显著差异(RR:0.99,95% CI:0.95-1.03;P=0.77;I 2=0%)。两组之间的心血管疾病死亡率也无明显差异(RR:0.97,95% CI:0.90-1.05;P=0.72;I2=0%)。在队列研究中,循环 25 (OH) D 使心血管疾病发病风险增加 31%(RR:1.31,95% CI:1.19-1.45),使心血管疾病死亡率增加 37%(RR:1.37,95% CI:1.17-1.61)。结论根据目前的临床试验证据,不应建议将补充维生素 D 用于预防心血管疾病。然而,维生素 D 缺乏与心血管疾病的发病率和死亡率有直接关系。根据科学证据水平较高的临床试验研究结果,可以得出结论,补充维生素 D 对心血管疾病的发病率、死亡率和减少心血管疾病的发生率并无显著影响。
Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 134000 Individuals in 29 Randomized Clinical Trials and 157000 Individuals in 30 Prospective Cohort Studies: An Updated Systematic Review and Meta-analysis
Background: According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials. Study Design: A systematic review. Methods: MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel’s random-effects model. Then, Stata version 14 was used for statistical analysis. Results: In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; P=0.77; I 2=0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; P=0.72; I2=0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61). Conclusion: According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. According to the results of clinical trial studies carrying higher levels of scientific evidence, it can be concluded that vitamin D supplementation does not exert a significant effect on the incidence, mortality, and reduction of CVDs.
期刊介绍:
The Journal of Research in Health Sciences (JRHS) is the official journal of the School of Public Health; Hamadan University of Medical Sciences, which is published quarterly. Since 2017, JRHS is published electronically. JRHS is a peer-reviewed, scientific publication which is produced quarterly and is a multidisciplinary journal in the field of public health, publishing contributions from Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine. We do not publish clinical trials, nursing studies, animal studies, qualitative studies, nutritional studies, health insurance, and hospital management. In addition, we do not publish the results of laboratory and chemical studies in the field of ergonomics, occupational health, and environmental health