The association between circulating 25-hydroxyvitamin D and cardiovascular diseases: a meta-analysis of prospective cohort studies

Fatemeh Gholami, Ghobad Moradi, Bushra Zareei, Mohammad Aziz Rasouli, Bahram Nikkhoo, Daem Roshani, Ebrahim Ghaderi, Fatemeh Gholami, Ghobad Moradi, Bushra Zareei, Mohammad Aziz Rasouli, Bahram Nikkhoo, Daem Roshani, Ebrahim Ghaderi

Abstract

Background: There is a controversy about the association between vitamin D and cardiovascular diseases (CVDs). The effect of serum 25-OH-vitD on the risk of CVDs was evaluated.

Methods: Major electronic databases including Scopus, Science Direct, and PubMed were searched. All prospective cohort studies on the relationship between vitamin D status and CVDs conducted between April 2000 and September 2017 were included, regardless language. The study participants were evaluated regardless of their age, sex, and ethnicity. The Newcastle-Ottawa Scale was used to assess the quality of the studies. Two investigators independently selected the studies and extracted the data. The designated effects were risk ratio (RR) and hazard ratio (HR). The random effects model was used to combine the results.

Results: A meta-analysis of 25 studies with 10,099 cases of CVDs was performed. In general, a decrease in the level of vitamin D was associated with a higher relative risk of CVDs (incidence-mortality combined) (RR = 1.44, 95% CI: 1.24-1.69). This accounts for 54% of CVDs mortality rate (RR = 1.54, 95% CI: 1.29-1.84(. However, no significant relationship was observed between the vitamin D status and incidence of CVDs (RR = 1.18, 95% CI: 1-1.39). In general, low serum vitamin D level increased the risk of CVD by 44% (RR = 1.44, 95% CI: 1.24-1.69). It also increased the risk of CVD mortality (RR = 1.54, 95% CI: 1.29-1.84) and incidence rates (RR = 1.18, 95% CI: 1-1.39).

Conclusions: The findings showed that vitamin D deficiency increases the CVDs mortality rate. Due to the limited number of studies on patients of the both genders, further research is suggested to separately evaluate the effect of vitamin D status on CVD in men and women.

Keywords: Cardiovascular disease; Meta-analysis; Prospective cohort study; Vitamin D.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process. As shown our initial searches resulted in 13,939 citations. After screening title and abstracts, 46 studies were considered potentially eligible and retrieved in full text, of these 25 studies were subsequently included in the meta-analysis
Fig. 2
Fig. 2
The association of vitamin D with total cardiovascular diseases events, cardiovascular diseases incidence and cardiovascular diseases mortality. The size of gray box is positively proportional to the weight assigned to each study, and horizontal lines represent the 95% confidence intervals
Fig. 3
Fig. 3
Funnel plot for the analysis of vitamin D and cardiovascular diseases

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