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The impact of vitamin D supplement intake on vascular endothelial function; a systematic review and meta-analysis of randomized controlled trials.

ABSTRACT: Aim: to systematically review and conduct a meta-analysis of randomized controlled trials investigating the impact of vitamin D supplementation on endothelial function. Method: We searched PubMed-Medline, SCOPUS, Web of Science and Google Scholar (until June 2016) to detect prospective studies evaluating the impact of vitamin D supplementation on endothelial function indexes. We used random effects models (using DerSimonian-Laird method) and generic inverse variance methods to synthesize quantitative data. We used the leave-one-out method for sensitivity analysis. To quantitatively assess the heterogeneity we used the I2 index. Systematic review registration: CRD42016039329. Results: From a total of 213 entries identified, 12 studies were appropriate for inclusion into the final analysis. The meta-analysis indicated a significant enhancement in flow-mediated dilation (FMD) following D supplementation (vitamin D intervention group versus control group 1.27 %, (95% CI 0.20 to 2.34, N = 11 arms, heterogeneity p = 0.054; I2 51.2 %). These findings were robust in sensitivity analyses. Conclusions: This meta-analysis suggested that vitamin D supplementation may improve endothelial function. Randomized control trials with a longer-term follow-up are warranted to clarify the existing controversies and shed light on the potential underlying mechanisms.

SUBMITTER: Mazidi M

PROVIDER: S-EPMC5404423 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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The impact of vitamin D supplement intake on vascular endothelial function; a systematic review and meta-analysis of randomized controlled trials.

Mazidi Mohsen M Karimi Ehsan E Rezaie Peyman P Vatanparast Hassan H

Food & nutrition research 20170320 1

<b>Aim:</b> to systematically review and conduct a meta-analysis of randomized controlled trials investigating the impact of vitamin D supplementation on endothelial function. <b>Method:</b> We searched PubMed-Medline, SCOPUS, Web of Science and Google Scholar (until June 2016) to detect prospective studies evaluating the impact of vitamin D supplementation on endothelial function indexes. We used random effects models (using DerSimonian-Laird method) and generic inverse variance methods to synt ...[more]

PMID: 28469540

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Project description:BACKGROUND AND OBJECTIVES: Recent studies have supported a role for both newer and more established vitamin D compounds in improving proteinuria, although systematic evaluation is lacking. Furthermore, concerns remain regarding the influence of vitamin D on the progression of renal function. We analyzed the efficacy and safety of vitamin D in non-dialysis patients and compared the use of newer versus established vitamin D compounds by performing a meta-analysis of randomized controlled trials. DESIGN: A literature search of PubMed (1975 to September, 2012), EMBASE.com (1966 to September, 2012) and Ovid EBM Reviews (through September, 2012) was conducted. RESULTS: Eighteen studies were eligible for final inclusion; of these, six explored the effects of vitamin D on proteinuria, twelve studied the effects of supplementation on renal function, and fifteen discussed the incidence of hypercalcemia. Compared to the placebo or no interference, both the newer and established vitamin D sterols reduced proteinuria to a similar extent (RR, 2.00; 95% CI, 1.42 to 2.81). No decrease in the glomerular filter rate was observed (SMD, -0.10; 95%CI, -0.24 to 0.03), and the risk for dialysis initiation was 1.48 (95% CI, 0.54 to 4.03) with vitamin D treatment. Additionally, there was an increased risk of hypercalcemia for patients treated with either newer or established vitamin D compounds as compared with the controls (RR, 4.78; 95% CI, 2.20 to 10.37). The head-to-head studies showed no differences in the effects of either newer or established compounds on proteinuria or the risk of hypercalcemia. No serious adverse events were associated with the administration of vitamin D. CONCLUSIONS: Vitamin D therapy appears to decrease proteinuria and have no negative influence on renal function in non-dialysis patients. But the occurrence of hypercalcemia should be evaluated when vitamin D is provided. No superiority for newer versus established vitamin D analogue is found.

Project description:AimsVitamin E (Vit-E) may preferentially improve cardiovascular risk in haptoglobin 2-2 (Hp2-2) genotype diabetes individuals. We studied the impact of Vit-E supplementation on vascular function in diabetes individuals stratified by haptoglobin genotype in Singapore.MethodsIn this 24-week, double blind, placebo-controlled RCT, we recruited 187 subjects (101 Hp2-2, 86 non-Hp2-2).Interventionalpha-tocopherol-400 IU.Primary outcomeChange in EndoPAT-derived reactive-hyperaemia index (RHI) and augmentation index (AIx); Secondary Outcomes: Pulse-Wave velocity (Sphygmocor-PWV), carotid intima media thickness (CIMT), inflammation (hsCRP), derivatives of reactive-oxygen metabolites (dROMs), biological antioxidant-potential (BAPs), HbA1c, LDL-C, HDL-C and oxidised LDL-C (ox-LDL).ResultsOverall, with Vit-E supplementation no significant change in RHI, PWV, CIMT, hsCRP, dROMS, BAPs, HDL-C and HbA1c was observed (p > 0.05); an increase in LDL-C with concomitant decrease in ox-LDL, and incidentally increase in eGFR was observed (p < 0.05). No interaction effect with haptoglobin genotype was seen for all outcomes (p > 0.05). Subgroup analysis: In the non-Hp-2-2 group, Vit-E supplementation led to a higher EndoPAT-derived AIx, accompanied by higher LDL and ox-LDL concentrations (p < 0.05); Hp2-2 group: Vit-E supplementation led to higher eGFR when compared to the non-Hp2-2 group (exploratory) (p < 0.05). We observed an interaction effect for baseline haptoglobin concentration (threshold > 119 mg/dl) with intervention in terms of increased EndoPAT-derived AIx in the Hp > 119 mg/dl group whereas no change in the group with Hp ≤ 119 mg/dl.ConclusionVit-E supplementation did not show any preferential benefit or deleterious effect on vascular function in Hp2-2 diabetes subjects in Singapore. A possible deleterious effect of an increase in arterial stiffness in individuals with Hp > 119 mg/dl was observed. Future studies should consider personalisation based on baseline Hp concentrations in patients with T2DM rather than just Hp2-2 genotype to evaluate impact on the detailed lipid pathways, cardiac and renal physiology. The impact of ethnic differences needs to be explored in greater details.

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The impact of vitamin D supplement intake on vascular endothelial function; a systematic review and meta-analysis of randomized controlled trials.

Publications

The impact of vitamin D supplement intake on vascular endothelial function; a systematic review and meta-analysis of randomized controlled trials.

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