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Vitamin D regulates a wide array of genes involved in inflammation and immunity,
inconsistently associated with reduced risk of several autoimmune diseases in observational studies
Active form of vitamin D regulates genes, inflammation, acquired and innate immune responses
Dietary marine derived long chain omega 3 fatty acids decrease systemic inflammation in some autoimmune diseases
Evidence is needed on whether omega 3 fatty acids lower the risk of developing autoimmune disease
Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial
www.bmj.com/content/376/bmj-2...
To investigate whether vitamin D and marine derived long chain omega 3 fatty acids reduce autoimmune disease risk.
Vitamin D and omega 3 trial (VITAL), a nationwide (US), randomized, double blind, placebo controlled trial
N = 25, 871
consisting of,
12, 786 men ≥50
13, 085 women ≥55
18,046 non- Hispanic white
5,106 black
2,152 as other racial and ethnic groups
Mean age was 67.1
INTERVENTIONS
Vitamin D (2000 IU/day) or placebo
Omega 3 fatty acids (1000 mg/day) or placebo
Participants self-reported all incident autoimmune diseases from baseline to a median of 5.3 years,
these diseases were confirmed by medical record review
In the vitamin D arm
Treatment group
123 developed an autoimmune disease
Placebo group
155 developed an autoimmune disease
Hazard ratio 0.78
P = 0.05
In the omega 3 fatty acids arm
Treatment group
130 developed an autoimmune disease
Placebo group
148 developed an autoimmune disease
P=0.19
CONCLUSIONS
Vitamin D supplementation for five years
with or without omega 3 fatty acids,
reduced autoimmune disease by 22%
Omega 3 fatty acid supplementation
with or without vitamin D,
reduced the autoimmune disease rate by 15%
(not statistically significant)
The clinical importance of this trial is high because these are well tolerated, non-toxic supplements,
and other effective treatments to reduce the incidence of autoimmune diseases are lacking
Autoimmune diseases
Rheumatoid arthritis
Polymyalgia rheumatica
Hashimoto’s thyroiditis, too little thyroid hormone)
Psoriasis
Type 1 diabetes mellitus
Multiple sclerosis
Lupus
Inflammatory bowel disease (Crohn’s Ulcerative colitis)
Addison’s (too little of cortisol)
Grave’s (too much thyroid hormone),
Myasthenia gravis
Pernicious anemia
Autoimmune vasculitis
Celiac disease (gluten protein from grains)
Inflammatory autoimmune response to self-tissues
Third leading cause of morbidity in the industrialized world
Chronic conditions
Increasing prevalence with age
Lack of effective treatments
More about the VITAL RCT
clinicaltrials.gov/ct2/show/N...
VITamin D and OmegA-3 TriaL (VITAL)
A randomized clinical trial, US based
N = 25,871
Investigating
Daily dietary supplements of vitamin D3 (2000 IU),
or omega-3 fatty acids (Omacor® fish oil, 1 gram),
reduces the risk of developing,
cancer
heart disease
stroke,
in people with no specific history
5-year intervention phase (study pill-taking, median 5.3 years) has ended
post-intervention observational follow-up, ongoing
15 июл 2024
