Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure : a double-blind , randomized , placebo-controlled trial 1 – 3
Background: Elevated circulating concentrations of proinflammatory cytokines may contribute to the pathogenesis of congestive heart failure (CHF). In vitro studies suggest that vitamin D suppresses proinflammatory cytokines and increases antiinflammatory cytokines. Objective: We evaluated the effect of vitamin D supplementation on the survival rate and different biochemical variables in patients with CHF. Design: One hundred twenty-three patients randomly received either 50 g vitamin D3/d plus 500 mg Ca/d [D( ) group] or placebo plus 500 mg Ca/d [D(–) group] for 9 mo. Biochemical variables were assessed at baseline and after 9 mo. The survival rate was calculated for a follow-up period of 15 mo. Results: Ninety-three patients completed the study. Significant treatment effects were observed on logarithmic-transformed serum concentrations of 25-hydroxyvitamin D (P 0.001), parathyroid hormone (P 0.007), tumor necrosis factor (P 0.006), and interleukin 10 (P 0.042). 25-Hydroxyvitamin D increased by 26.8 ng/mL in the D( ) group but increased only by 3.6 ng/mL in the D(–) group. Compared with baseline, parathyroid hormone was significantly lower and the antiinflammatory cytokine interleukin 10 was significantly higher in the D( ) group after 9 mo. The proinflammatory cytokine tumor necrosis factor increased in the D(–) group but remained constant in the D( ) group. The survival rate did not differ significantly between the study groups during the follow-up period. Conclusions: Vitamin D3 reduces the inflammatory milieu in CHF patients and might serve as a new antiinflammatory agent for the future treatment of the disease. Our data provide evidence for the involvement of an impaired vitamin D–parathyroid hormone axis in the progression of CHF. Am J Clin Nutr 2006;83:754–9.