Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial.
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.


METHODS
One hundred twenty-three patients randomly received either 50 mug vitamin D(3)/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 alpha (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 alpha 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 D(3) 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.
Schleithoff
Stefanie S
SS
Institute of Nutrition and Food Science, University of Bonn, Bonn, Germany.
Zittermann
Armin
A
Tenderich
Gero
G
Berthold
Heiner K
HK
Stehle
Peter
P
Koerfer
Reiner
R
D002908:Chronic Disease; D019587:Dietary Supplements; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage* / Q000097:blood
D010281:Parathyroid Hormone; D014409:Tumor Necrosis Factor-alpha; D014815:Vitamins; D016753:Interleukin-10; D014807:Vitamin D; C104450:25-hydroxyvitamin D