A groundbreaking systematic review and meta-analysis, conducted by researchers from institutions in China and the United States has revealed the significant impact of vitamin D supplementation on cardiometabolic health. Published in the Journal of Engineering, the study holds important implications for developing personalized therapeutic strategies to combat cardiovascular diseases and related risk factors.
Vitamin D plays a crucial role in maintaining cardiometabolic health through several mechanisms in the body. Once activated in the liver and kidneys, vitamin D binds to the vitamin D receptor (VDR), which is present in various tissues, including the cardiovascular system, pancreas, and immune cells. This binding regulates the expression of genes involved in calcium and phosphate homeostasis, essential for maintaining proper vascular function and blood pressure. Vitamin D also has anti-inflammatory and anti-oxidative properties, reducing levels of pro-inflammatory cytokines and oxidative stress, both of which contribute to cardiovascular diseases. Additionally, it improves insulin sensitivity and modulates glucose metabolism, which helps prevent diabetes which is a key cardiometabolic risk factor.
This comprehensive review analyzed data from 99 randomized controlled trials (RCTs), encompassing 17,656 participants. The study found that vitamin D supplementation, at a median dose of 3320 International Units (IU) per day, positively influenced several cardiometabolic risk factors. These included reductions in systolic and diastolic blood pressure, total cholesterol, fasting blood glucose, haemoglobin A1C, and fasting blood insulin, all key markers of cardiometabolic health.
The researchers identified that the benefits of vitamin D supplementation were most remarkable in specific subgroups. These groups included non-Western populations, individuals with baseline 25-hydroxyvitamin D levels below 15.0 ng/mL, those with a body mass index (BMI) under 30 kg/m², and older adults aged 50 and above. This finding suggests that vitamin D supplementation may be particularly effective in populations with lower baseline vitamin D levels or higher risk factors for cardiometabolic conditions.
One of the significant contributions of the study is its emphasis on personalized vitamin D interventions designed for individual characteristics such as ethnocultural background, age, BMI, and initial vitamin D levels. The researchers suggested that personalized strategies, rather than a one-size-fits-all approach, could be more effective for vitamin D supplementation in preventing and managing cardiometabolic diseases. They also mentioned that longer supplementation periods (three months or more) and higher doses might be necessary, especially for targeted populations, to achieve these health benefits.
The potential public health implications of this research are profound. Cardiovascular diseases remain one of the leading causes of death worldwide, and the development of more effective preventive strategies could significantly reduce the global burden of these conditions. The role of vitamin D in cardiometabolic health opens new avenues for public health initiatives, especially in regions or populations that are more prone to vitamin D deficiency due to limited sunlight exposure or dietary intake.
Despite these promising findings, the researchers also caution that further research is needed. Future studies should aim to better understand the underlying mechanisms driving these benefits and explore the long-term effects of vitamin D supplementation. Additionally, the safety of high-dose supplementation must be evaluated, as prolonged use of large doses could pose risks.
References
- An P, Wan S, Wang L, Xu T, Xu T, Wang Y, et al. Modifiers of the Effects of Vitamin D Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Engineering [Internet]. 2024 Jul 26 [cited 2024 Sep 10]; Available from: https://www.sciencedirect.com/science/article/pii/S2095809924003990
- Agbalalah T, Mushtaq S. Effect of vitamin D3 supplementation on cardiometabolic disease risk among overweight/obese adult males in the UK: A pilot randomised controlled trial. J Hum Nutr Diet. 2023 Feb;36(1):216–25.