Armin Zittermann1, Jana B Ernst2, Ingvild Birschmann3, Marcus Dittrich4. 1. Clinic for Thoracic and Cardiovascular Surgery and azittermann@hdz-nrw.de. 2. Clinic for Thoracic and Cardiovascular Surgery and. 3. Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany; 4. Department of Bioinformatics, Biocenter, University of Wuerzburg, Wuerzburg, Germany; Institute of Human Genetics, University of Wuerzburg, Wuerzburg, Germany.
Abstract
BACKGROUND: Evidence is accumulating that circulating 1,25-dihydroxyvitamin D [1,25(OH)2D] concentrations are inversely related to overall mortality. METHODS: We searched PubMed, Embase and ISI Web of Science for randomized controlled trials with a control group receiving a placebo instead of vitamin D/activated vitamin D and performed a metaanalysis to evaluate the effect of oral vitamin D/activated vitamin D on circulating 1,25(OH)2D concentrations using a random effects model. RESULTS: We included 52 vitamin D intervention groups (4796 individuals) and 14 intervention groups with activated vitamin D (668 individuals). Vitamin D supplements increased circulating 1,25(OH)2D by 12.2 pmol/L (95% CI, 7.8-16.5 pmol/L) and 18.8 pmol/L (95% CI, 9.2-28.4 pmol/L) if only studies with a low risk of bias in study design and reporting were considered (n = 18). There was significant heterogeneity among studies (Cohran's Q P < 0.001, I(2) = 91%). The incremental effect was larger in studies using vitamin D alone compared with coadministration of calcium supplements (18.6 pmol/L; 95% CI, 12.7-24.4 pmol/L vs 4.9 pmol/L; 95% CI, -0.4 to 10.2 pmol/L; P = 0.001), and if quantification was performed with RIA vs other methods (17.1 pmol/L; 95% CI, 11.1-23.1 pmol/L vs 6.9 pmol/L; 95% CI, 1.0-12.8 pmol/L; P = 0.02). Activated vitamin D increased the mean circulating 1,25(OH)2D by 20.5 pmol/L (95% CI, 8.3-32.7 pmol/L; P = 0.04). Again, there was evidence for significant heterogeneity among studies (Cochran Q = 85.4; P < 0.001; I(2) = 87%), but subgroup analysis did not identify parameters significantly influencing the increment in 1,25(OH)2D concentrations. CONCLUSIONS: Both vitamin D and activated vitamin D significantly increase circulating 1,25(OH)2D concentrations, but in vitamin D users this increase is suppressed by calcium coadministration.
BACKGROUND: Evidence is accumulating that circulating 1,25-dihydroxyvitamin D [1,25(OH)2D] concentrations are inversely related to overall mortality. METHODS: We searched PubMed, Embase and ISI Web of Science for randomized controlled trials with a control group receiving a placebo instead of vitamin D/activated vitamin D and performed a metaanalysis to evaluate the effect of oral vitamin D/activated vitamin D on circulating 1,25(OH)2D concentrations using a random effects model. RESULTS: We included 52 vitamin D intervention groups (4796 individuals) and 14 intervention groups with activated vitamin D (668 individuals). Vitamin D supplements increased circulating 1,25(OH)2D by 12.2 pmol/L (95% CI, 7.8-16.5 pmol/L) and 18.8 pmol/L (95% CI, 9.2-28.4 pmol/L) if only studies with a low risk of bias in study design and reporting were considered (n = 18). There was significant heterogeneity among studies (Cohran's Q P < 0.001, I(2) = 91%). The incremental effect was larger in studies using vitamin D alone compared with coadministration of calcium supplements (18.6 pmol/L; 95% CI, 12.7-24.4 pmol/L vs 4.9 pmol/L; 95% CI, -0.4 to 10.2 pmol/L; P = 0.001), and if quantification was performed with RIA vs other methods (17.1 pmol/L; 95% CI, 11.1-23.1 pmol/L vs 6.9 pmol/L; 95% CI, 1.0-12.8 pmol/L; P = 0.02). Activated vitamin D increased the mean circulating 1,25(OH)2D by 20.5 pmol/L (95% CI, 8.3-32.7 pmol/L; P = 0.04). Again, there was evidence for significant heterogeneity among studies (Cochran Q = 85.4; P < 0.001; I(2) = 87%), but subgroup analysis did not identify parameters significantly influencing the increment in 1,25(OH)2D concentrations. CONCLUSIONS: Both vitamin D and activated vitamin D significantly increase circulating 1,25(OH)2D concentrations, but in vitamin D users this increase is suppressed by calcium coadministration.
Authors: Alexander Teumer; Giovanni Gambaro; Tanguy Corre; Murielle Bochud; Peter Vollenweider; Idris Guessous; Marcus E Kleber; Graciela E Delgado; Stefan Pilz; Winfried März; Catriona L K Barnes; Peter K Joshi; James F Wilson; Martin H de Borst; Gerjan Navis; Pim van der Harst; Hiddo J L Heerspink; Georg Homuth; Karlhans Endlich; Matthias Nauck; Anna Köttgen; Cristian Pattaro; Pietro Manuel Ferraro Journal: Nephrol Dial Transplant Date: 2018-12-01 Impact factor: 7.186
Authors: Armin Zittermann; Jana B Ernst; Stefan Pilz; Jens Dreier; Joachim Kuhn; Cornelius Knabbe; Jan F Gummert; Michiel Morshuis; Hendrik Milting Journal: PLoS One Date: 2016-10-27 Impact factor: 3.240
Authors: J B Ernst; S Prokop; U Fuchs; J Dreier; J Kuhn; C Knabbe; H K Berthold; S Pilz; I Gouni-Berthold; J F Gummert; J Börgermann; A Zittermann Journal: Nutr J Date: 2017-08-23 Impact factor: 3.271
Authors: Christian Trummer; Verena Schwetz; Marlene Pandis; Martin R Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Claudia Friedl; Andreas Tomaschitz; Barbara Obermayer-Pietsch; Thomas R Pieber; Stefan Pilz; Gerlies Treiber Journal: Nutrients Date: 2017-06-17 Impact factor: 5.717
Authors: Jana B Ernst; Andreas Tomaschitz; Martin R Grübler; Martin Gaksch; Katharina Kienreich; Nicolas Verheyen; Winfried März; Stefan Pilz; Armin Zittermann Journal: Int J Endocrinol Date: 2016-02-23 Impact factor: 3.257
Authors: Armin Zittermann; Jana B Ernst; Tobias Becker; Jens Dreier; Cornelius Knabbe; Jan F Gummert; Joachim Kuhn Journal: Int J Anal Chem Date: 2016-04-05 Impact factor: 1.885
Authors: Susanne Vogt; Simone Wahl; Johannes Kettunen; Susanne Breitner; Gabi Kastenmüller; Christian Gieger; Karsten Suhre; Melanie Waldenberger; Jürgen Kratzsch; Markus Perola; Veikko Salomaa; Stefan Blankenberg; Tanja Zeller; Pasi Soininen; Antti J Kangas; Annette Peters; Harald Grallert; Mika Ala-Korpela; Barbara Thorand Journal: Int J Epidemiol Date: 2016-09-07 Impact factor: 7.196