Effects of vitamin D supplementation on markers for cardiovascular disease and type 2 diabetes: an individual participant data meta-analysis of randomized controlled trials. Issue 6 (4th June 2018)

• Record Type: Journal Article
• Authors: Swart, Karin MA; Lips, Paul; Brouwer, Ingeborg A; Jorde, Rolf; Heymans, Martijn W; Grimnes, Guri; Grübler, Martin R; Gaksch, Martin; Tomaschitz, Andreas; Pilz, Stefan; Eiriksdottir, Gudny; Gudnason, Vilmundur; Wamberg, Louise; Rejnmark, Lars; Sempos, Christopher T; Durazo-Arvizu, Ramón A; Dowling, Kirsten G; Hull, George; Škrabáková, Zuzana; Kiely, Mairead; Cashman, Kevin D; van Schoor, Natasja M
• Is Part Of: American journal of clinical nutrition. Volume 107:Issue 6(2018)
• Page Start: 1043
• Page End: 1053
• Publication Date: 2018-06-04
• Subjects: individual participant meta-analysis -- vitamin D -- randomized controlled trials -- subgroups -- cardiovascular disease -- type 2 diabetes -- ODIN -- remeasured 25-hydroxyvitamin D; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqy078
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Evidence from randomized controlled trials (RCTs) for the causal role of vitamin D on noncommunicable disease outcomes is inconclusive. Objective: The aim of this study was to investigate whether there are beneficial or harmful effects of cholecalciferol (vitamin D3 ) supplementation according to subgroups of remeasured serum 25-hydroxyvitamin D [25(OH)D] on cardiovascular and glucometabolic surrogate markers with the use of individual participant data (IPD) meta-analysis of RCTs. Design: Twelve RCTs (16 wk to 1 y of follow-up) were included. For standardization, 25(OH)D concentrations for all participants ( n = 2994) at baseline and postintervention were re-measured in bio-banked serum samples with the use of a certified liquid chromatography–tandem mass spectrometry method traceable to a reference measurement procedure. IPD meta-analyses were performed according to subgroups of remeasured 25(OH)D. Main outcomes were blood pressure and glycated hemoglobin (HbA1c). Secondary outcomes were LDL, HDL, and total cholesterol and triglycerides; parathyroid hormone (PTH); fasting glucose, insulin, and C-peptide; and 2-h glucose. In secondary analyses, other potential effect modifiers were studied. Results: Remeasurement of 25(OH)D resulted in a lower mean 25(OH)D concentration in 10 of 12 RCTs. Vitamin D supplementation had no effect on the main outcomes of blood pressure and HbA1c. Supplementation resulted in 10–20% lower PTH concentrations, irrespective of the 25(OH)D subgroups. The subgroup analyses according to achieved 25(OH)D concentrations showed a significant decrease in LDL-cholesterol concentrations after vitamin D supplementation in 25(OH)D subgroups with <75, <100, and <125 nmol of −0.10 mmol/L (95% CI: −0.20, −0.00 mmol/L), −0.10 mmol/L (95% CI: −0.18, −0.02 mmol/L), and −0.07 mmol/L (95% CI: −0.14, −0.00 mmol/L), respectively. Patient features that modified the treatment effect could not be identified. Conclusions: For the main outcomes of blood pressure and HbA1c, the data support no benefit for vitamin D supplementation. For the secondary outcomes, in addition to its effect on PTH, we observed indications for a beneficial effect of vitamin D supplementation only on LDL cholesterol, which warrants further investigation. This trial was registered at www.clinicaltrials.gov as NCT02551835.