The inconsistent findings concerning the effects of vitamin D supplementation on cardiometabolic risk factors and the large heterogeneity in the published literature call for further research to identify sources of heterogeneity and potential effect modifiers. We performed a meta-analysis of randomized controlled trials (RCTs) published until March 2024 that reported estimates for the effects of vitamin D supplementation on cardiometabolic factors and relevant baseline covariates of RCT participants. A total of 17 656 participants from 99 RCTs were analyzed, and weighted mean differences (95% confidence intervals (CI)) for the intervention status were derived using random-effects modeling. Overall, compared with the placebo, vitamin D supplementation (median dose: 3320 international unit (IU)·day−1; range 40–120 000 IU·day−1) had favorable effects on systolic blood pressure (SBP; −2.04(−3.50, −0.59) mmHg; 1 mmHg = 0.133 kPa), diastolic blood pressure (DBP; −3.00(−3.61, −2.39) mmHg), total cholesterol (TC; −0.12(−0.21, −0.03) mmol·L−1), fasting blood glucose (FBG; −0.13(−0.20, −0.05) mmol·L−1), hemoglobin A1C (A1C; −0.09% (−0.13%, −0.05%)), and fasting blood insulin (FBI: −7.61 (−11.93, −3.30) pmol·L−1). The benefits of vitamin D were most evident in trials performed in non-Westerners, participants with baseline 25-hydroxyvitamin D (25[OH]D) lower than 15.0 ng·mL−1, non-obese (body mass index (BMI) < 30 kg·m−2), and older (age ≥ 50 years). The findings of this study underscore the need for personalized vitamin D intervention strategies that comprehensively account for individual patient characteristics (such as ethnocultural background, age, BMI, and circulating 25[OH]D level), intervention dosage, and intervention duration to optimize cardiometabolic health outcomes.

中文翻译：

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维生素 D 补充剂对心脏代谢危险因素影响的调节因素：系统评价和荟萃分析


关于维生素 D 补充剂对心脏代谢危险因素影响的不一致发现以及已发表文献中的巨大异质性，需要进一步研究以确定异质性的来源和潜在的影响调节因素。我们对截至 2024 年 3 月发表的随机对照试验 （RCT） 进行了荟萃分析，这些试验报告了维生素 D 补充剂对 RCT 参与者心脏代谢因素和相关基线协变量影响的估计值。共分析了来自 99 项 RCT 的 17 656 名参与者，并使用随机效应模型得出干预状态的加权均数差 （95% 置信区间 （CI））。总体而言，与安慰剂相比，维生素 D 补充剂（中位剂量：3320 国际单位 （IU）·天−1;范围 40-120 000 IU·天−1）对收缩压（收缩压;-2.04（−3.50，-0.59）mmHg;1 mmHg = 0.133 kPa）、舒张压（DBP;−3.00（−3.61，−2.39）mmHg）、总胆固醇（TC;−0.12（−0.21，−0.03）mmol·L−1）、空腹血糖（FBG;−0.13（−0.20，−0.05）mmol·L−1）、血红蛋白 A1C（A1C;-0.09%（-0.13%，-0.05%））和空腹血胰岛素（FBI：-7.61（-11.93，-3.30）pmol·L−1）。维生素 D 的好处在非西方人、基线 25-羟基维生素 D （25[OH]D） 低于 15.0 ng·mL-1、非肥胖（体重指数 （BMI） < 30 kg·m-2）和年龄较大（年龄≥ 50 岁）的参与者中最为明显。这项研究的结果强调了个性化维生素 D 干预策略的必要性，该策略全面考虑了个体患者的特征（如种族文化背景、年龄、BMI 和循环 25[OH]D 水平）、干预剂量和干预持续时间，以优化心脏代谢健康结果。