The Effects of Vitamin D Supplementation on C-Reactive Protein and Systolic and Diastolic Blood Pressure in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.

BACKGROUND: An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE: This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS: Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS: Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS: This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.

Effect of Adopting Low Calories on Patients' Vital Signs in The Nutritional Support of Critically Ill Patients in the ICU: A Systematic Review and Network Meta-Analysis.

Background: Feeding critically ill persons in Intensive Care Units (ICUs) is challenging as the nutritional substances pose severe health outcomes or can improve their well-being and length of stay (LOS) in the hospital. Our main objective is to investigate the effects of adopting low caloric intake among patients with vital signs in the nutritional support of critically ill patients in ICUs, focusing on reducing mortality rates and length of stay (LOS) in hospitals. Method: The initial literature search was performed in PubMed, the Cochrane Library of Trials, and MEDLINE. The network meta-analysis was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent reviewers were assigned data selection and extraction roles. Our study mainly included randomised controlled trials (RCTs) whose titles and abstracts were screened, after which duplicates were excluded. The remaining eligible studies were subjected to full-text analysis to identify data related to the topic of the present study. Analyses were performed using the Cochrane Risk of Bias tool, R software and MS Excel. Results: Twenty-two studies (involving 9 539 participants) met the inclusion criteria and were subjected to the network meta-analysis. In mortality rates, the greatest rank observed corresponded to a reduction of 71%. The regression of the effects of low caloric intake explained a 5.29% variation in LOS. A weak positive correlation was found between LOS and low caloric intake among critically ill patients in ICUs. Thus, Low caloric intake decreased mortality rates and lowered LOS. Conclusions: Our study found that low caloric intake reduces mortality rate and hospital LOS among critically ill patients. Secondary outcomes include nosocomial infection, clinical outcomes, functions, digestive infections, improved quality of life, resulting survival rates, ventilator days, bacteremia, blood glucose levels, diarrhoea, and tube replacement. Our findings have clinical implications for clinicians in the ICU, who should consider developing individualised nutritional plans for critically ill patients. Moreover, regular monitoring of nutritional intake and response is crucial. Healthcare providers should closely monitor patients' nutritional status, vital signs, and clinical outcomes.