補充維生素D對血壓影響的系統評價_《中國循證醫學雜志》

作者：

張難 ,  徐新娟 , 珠勒皮亞司馬義

新疆醫科大學第一附屬醫院高血壓科（烏魯木齊 830000）;

關鍵詞：

維生素D 血壓系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20130016

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價補充維生素D對血壓的影響，為臨床治療提供依據。
方法　計算機檢索CENTRAL、PubMed、EMbase、CNKI和WanFang Data，收集關于補充維生素D對血壓影響的隨機對照試驗，檢索時限均為建庫至2011年8月。由2位評價者根據納入標準獨立篩選文獻、提取資料并評價質量后，采用RevMan 5.0軟件進行Meta分析。
結果　最終納入8個RCT，共907例患者。采用改良Jadad評分評價納入研究的方法學質量，7篇為4～7分，1篇低于4分。Meta分析結果顯示：與安慰劑相比，補充維生素D對收縮壓、舒張壓的影響差異均無統計學意義。
結論　目前研究證據顯示，與安慰劑相比，補充維生素D無論是對舒張壓還是收縮壓均無顯著影響。受納入研究數量所限，上述結論尚需開展更多設計嚴謹、大樣本、多中心的隨機對照試驗加以驗證。

引用本文： 張難,徐新娟,珠勒皮亞司馬義. 補充維生素D對血壓影響的系統評價. 中國循證醫學雜志, 2013, 13(1): 86-92. doi: 10.7507/1672-2531.20130016 復制

1.	Giovannucci E. The epidemiology of vitamin D and cancer incidence and mort ality:a review. Cancer Causes Control, 2005, 16(2): 83-95.
2.	Hayes CE. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc, 2000, 59(11): 531-535.
3.	Cantorna MT, Zhu Y, Froicu M, et al. Vitamin D status, 1,25-dihydroxyvita -minD3 , and the immune system. Am J Clin Nutr, 2004, 80(6): 1717S-1720S.
4.	Cheung PS, Thompson NW, Brothers TE, et al. Effect of hyperparathyroidism on the control of diabetes mellitus. Surgery, 1986, 100(14): 1039-1047.
5.	Taylor WH. The prevalence of diabetes mellitus in patients with primary hyperpar -athyroidism and among their relatives. Diabet Med, 1991, 8(6): 683-687.
6.	Werner S, Hjern B, Sjoberg HE. Primary hyperparathyroidism: analysis of findings in a series of 129 patients. Acta Chir Scand, 1974, 140(12): 618-625.
7.	Almirall J, Vaqueiro M, Bar´e ML, et al. Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Nephrol Dial Transplant, 2010, 25(1): 503-509.
8.	Holick MF. Vitamin D deficiency. N Eng J Med, 2007, 357(15): 266-281.
9.	Chalmers J, MacMahon S, Mancia G, et al. 1999 World Health Organization International Society of Hypertension Guidelines for the management of hypertension. Guidelines subcommittee of the World Health Organization. J Clin Exp Hypertens, 1999, 21(5-6): 1009-1060.
10.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials is blinding necessary? Control Clin Trials, 1996, 17(1): 1.
11.	Jorde R, Sneve M, Torjesen P, et al. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. J Intern Med, 2010, 267(12): 462-472.
12.	Zittermann A, Frisch S, Berthold HK, et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardio-vascular disease risk markers. Am J Clin Nutr, 2009, 89(2): 1321-1327.
13.	Nagpal J, Pande JN, Bhartia A. A double-blind, randomized, placebo-contr -olled trial of the short-term effect of vitamin D supplementation on insulin sensitivity in apparently healthy, middle-aged,centrally obese men. Diabet Med, 2009, 26(5): 19-27.
14.	Pfeifer M, Begerow B, Minne HW, et al. Effects of a short- term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, 2001, 86(6): 1633-1637.
15.	Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr, 1995, 49(10): 640-646.
16.	Pan WH, Wang CY, Li LA, et al. No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol, 1993, 36(3): 85-94.
17.	Myrup B, Jensen GF, McNair P. Cardiovascular risk factors during estrogen -norethindrone and cholecalciferol treatment. Arch Intern Med, 1992, 152(12): 2265- 2268.
18.	Lind L, Wengle B, Wide L, et al. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo controlled study. Am J Hypertens, 1989, 2(3): 20-25.
19.	Oladipo CO, Egbe PE, Ibu JO, et al. Interactions between sodium intake, calcium supp lement, renal excretion and blood pressure in Sprague 2 dawley rats. Niger Postgrad Med J, 2006, 13(4): 2822-2901.
20.	Porsti I, Fan M, Koobi P, et al. High calcium diet down 2 regulates kidney angiotensin converting enzyme in experimental renal failure. Kidney Int, 2004, 66(6): 21552-21661.
21.	Massry SG, Smogorzewsk IM. The effects of serum calcium and parthyroid hormone and the interaction between them on blood pressure in normal subjects and in patients with chronic kidney failure. JR en Nutr, 2005, 15(1): 173-177.
22.	Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens, 1999, 12(2): 84-92.
23.	Burgaz A, Orsini N, Susanna C, et al. Blood 25-hydroxyvitamin D concentration and hypertension:a meta-analysis. Journal of Hypertension, 2011, 29(6): 636-645.
24.	Hsu JJ, Tintut Y, Demer LL. Vitamin D and osteogenic differentiation in the artery wall. Clin J Am Soc Nephrol, 2008, 3(5): 1542-1547.
25.	Hatton DC, Xue H, DeMerritt JA, et al. 1,25(OH)2 vitamin D3-induced alterations in vascular reactivity in the spontaneously hypertensive. Am J Med Sci, 1994, 2(1): 154-158.
26.	Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int, 1988, 43(13): 199-201.
27.	Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr, 1981, 34(23): 2359-2363.
28.	Hey H, Stockholm KH, Lund BJ, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes, 1982, 6(4): 473-479.
29.	Hyldstrup L, Andersen T, McNair P, et al. Bone metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol, 1993, 129(3): 393-398.
30.	Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1, 25-dihydroxy vitamin D concentrations in healthy adults. The Journal of Clinical Endocrinology & Metabolism, 2004, 89(3): 1196-1199.
31.	Norman AW, Frankel BJ, Heldt AM, et al. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science, 1980, 209(23): 823-825.
32.	Rammos G, Tseke P, Ziakka S. Vitamin D, the reninangiotensin system, and insulin resistance. International Urology and Nephrology, 2008, 40(2): 419-426.
33.	Geleijnse JM. Vitamin D and hypertension does the women’s health initiative solve the question? Hypertension, 2008, 52(3): 803-804.

1. Giovannucci E. The epidemiology of vitamin D and cancer incidence and mort ality:a review. Cancer Causes Control, 2005, 16(2): 83-95.
2. Hayes CE. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc, 2000, 59(11): 531-535.
3. Cantorna MT, Zhu Y, Froicu M, et al. Vitamin D status, 1,25-dihydroxyvita -minD3 , and the immune system. Am J Clin Nutr, 2004, 80(6): 1717S-1720S.
4. Cheung PS, Thompson NW, Brothers TE, et al. Effect of hyperparathyroidism on the control of diabetes mellitus. Surgery, 1986, 100(14): 1039-1047.
5. Taylor WH. The prevalence of diabetes mellitus in patients with primary hyperpar -athyroidism and among their relatives. Diabet Med, 1991, 8(6): 683-687.
6. Werner S, Hjern B, Sjoberg HE. Primary hyperparathyroidism: analysis of findings in a series of 129 patients. Acta Chir Scand, 1974, 140(12): 618-625.
7. Almirall J, Vaqueiro M, Bar´e ML, et al. Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Nephrol Dial Transplant, 2010, 25(1): 503-509.
8. Holick MF. Vitamin D deficiency. N Eng J Med, 2007, 357(15): 266-281.
9. Chalmers J, MacMahon S, Mancia G, et al. 1999 World Health Organization International Society of Hypertension Guidelines for the management of hypertension. Guidelines subcommittee of the World Health Organization. J Clin Exp Hypertens, 1999, 21(5-6): 1009-1060.
10. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials is blinding necessary? Control Clin Trials, 1996, 17(1): 1.
11. Jorde R, Sneve M, Torjesen P, et al. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. J Intern Med, 2010, 267(12): 462-472.
12. Zittermann A, Frisch S, Berthold HK, et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardio-vascular disease risk markers. Am J Clin Nutr, 2009, 89(2): 1321-1327.
13. Nagpal J, Pande JN, Bhartia A. A double-blind, randomized, placebo-contr -olled trial of the short-term effect of vitamin D supplementation on insulin sensitivity in apparently healthy, middle-aged,centrally obese men. Diabet Med, 2009, 26(5): 19-27.
14. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short- term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, 2001, 86(6): 1633-1637.
15. Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr, 1995, 49(10): 640-646.
16. Pan WH, Wang CY, Li LA, et al. No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol, 1993, 36(3): 85-94.
17. Myrup B, Jensen GF, McNair P. Cardiovascular risk factors during estrogen -norethindrone and cholecalciferol treatment. Arch Intern Med, 1992, 152(12): 2265- 2268.
18. Lind L, Wengle B, Wide L, et al. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo controlled study. Am J Hypertens, 1989, 2(3): 20-25.
19. Oladipo CO, Egbe PE, Ibu JO, et al. Interactions between sodium intake, calcium supp lement, renal excretion and blood pressure in Sprague 2 dawley rats. Niger Postgrad Med J, 2006, 13(4): 2822-2901.
20. Porsti I, Fan M, Koobi P, et al. High calcium diet down 2 regulates kidney angiotensin converting enzyme in experimental renal failure. Kidney Int, 2004, 66(6): 21552-21661.
21. Massry SG, Smogorzewsk IM. The effects of serum calcium and parthyroid hormone and the interaction between them on blood pressure in normal subjects and in patients with chronic kidney failure. JR en Nutr, 2005, 15(1): 173-177.
22. Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens, 1999, 12(2): 84-92.
23. Burgaz A, Orsini N, Susanna C, et al. Blood 25-hydroxyvitamin D concentration and hypertension:a meta-analysis. Journal of Hypertension, 2011, 29(6): 636-645.
24. Hsu JJ, Tintut Y, Demer LL. Vitamin D and osteogenic differentiation in the artery wall. Clin J Am Soc Nephrol, 2008, 3(5): 1542-1547.
25. Hatton DC, Xue H, DeMerritt JA, et al. 1,25(OH)2 vitamin D3-induced alterations in vascular reactivity in the spontaneously hypertensive. Am J Med Sci, 1994, 2(1): 154-158.
26. Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int, 1988, 43(13): 199-201.
27. Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr, 1981, 34(23): 2359-2363.
28. Hey H, Stockholm KH, Lund BJ, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes, 1982, 6(4): 473-479.
29. Hyldstrup L, Andersen T, McNair P, et al. Bone metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol, 1993, 129(3): 393-398.
30. Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1, 25-dihydroxy vitamin D concentrations in healthy adults. The Journal of Clinical Endocrinology & Metabolism, 2004, 89(3): 1196-1199.
31. Norman AW, Frankel BJ, Heldt AM, et al. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science, 1980, 209(23): 823-825.
32. Rammos G, Tseke P, Ziakka S. Vitamin D, the reninangiotensin system, and insulin resistance. International Urology and Nephrology, 2008, 40(2): 419-426.
33. Geleijnse JM. Vitamin D and hypertension does the women’s health initiative solve the question? Hypertension, 2008, 52(3): 803-804.

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補充維生素D對血壓影響的系統評價

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《中國循證醫學雜志》

補充維生素D對血壓影響的系統評價

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