Background: Vitamin D deficiency is related to increased cancer risk and deaths. However, whether vitamin D supplementation reduces cancer mortality remains unclear, and several randomized controlled trials yield inconsistent results. Methods: Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception until 28 June 2022, for randomized controlled trials investigating vitamin D supplementation. Pooled relative risks (RRs) and their 95% confidence intervals (CIs) were estimated. Trials with vitamin D supplementation combined with calcium supplementation versus placebo alone and recruiting participants with cancer at baseline were excluded in the present study. Results: This study included 12 trials with a total of 72,669 participants. Vitamin D supplementation did not reduce overall cancer mortality (RR 0.96, 95% CI 0.80–1.16). However, vitamin D supplementation was associated with a reduction in lung cancer mortality (RR 0.63, 95% CI 0.45–0.90). Conclusions: Vitamin D supplementation could not reduce cancer mortality in this highly purified meta-analysis. Further RCTs that evaluate the association between vitamin D supplementation and total cancer mortality are still needed.

Background: low vitamin D status has been associated with an increased incidence of cardiovascular events. However, whether vitamin D supplementation would reduce the incidence of cardiovascular events remains unclear. Purpose: To perform a systematic review and meta-analysis of the effect of vitamin D supplementation on the mortality and incidence of cardiovascular events. Data Sources: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from their inception until 3 May 2022. Study Selection: Two authors searched for randomized clinical trials that reported vitamin D supplementation’s effect on cardiovascular events outcomes. Data Extraction: Two authors conducted independent data extraction. Data Synthesis: We identified 41,809 reports; after exclusions, 18 trials with a total of 70,278 participants were eligible for analysis. Vitamin D supplementation was not associated with the mortality of cardiovascular events (RR 0.96, 95% CI 0.88–1.06, I2 = 0%), the incidence of stroke (RR 1.05, 95% CI 0.92–1.20, I2 = 0%), myocardial infarction (RR 0.97, 95% CI 0.87–1.09, I2 = 0%), total cardiovascular events (RR 0.97, 95% CI 0.91–1.04, I2 = 27%), or cerebrovascular events (RR 1.01, 95% CI 0.87–1.18, I2 = 0%). Limitation: Cardiovascular events were the secondary outcome in most trials and thus, might be selectively reported. Conclusion: In this meta-analysis of randomized clinical trials, vitamin D supplementation was not associated with a lower risk of cardiovascular events than no supplementation. These findings do not support the routine use of vitamin D supplementation in general.

ObjectiveMany peripheral inflammatory markers were reported to be associated with the prognosis of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to identify the most promising inflammatory factor that can improve existing predictive models.MethodsThe study was based on data from a 10 year retrospective cohort study at Sichuan University West China Hospital. We selected the well-known SAFIRE and Subarachnoid Hemorrhage International Trialists’ (SAHIT) models as the basic models. We compared the performance of the models after including the inflammatory markers and that of the original models. The developed models were internally and temporally validated.ResultsA total of 3,173 patients were included in this study, divided into the derivation cohort (n = 2,525) and the validation cohort (n = 648). Most inflammatory markers could improve the SAH model for mortality prediction in patients with aSAH, and the neutrophil-to-albumin ratio (NAR) performed best among all the included inflammatory markers. By incorporating NAR, the modified SAFIRE and SAHIT models improved the area under the receiver operator characteristics curve (SAFIRE+NAR vs. SAFIRE: 0.794 vs. 0.778, p = 0.012; SAHIT+NAR vs. SAHIT: 0.831 vs. 0.819, p = 0.016) and categorical net reclassification improvement (SAFIRE+NAR: 0.0727, p = 0.002; SAHIT+NAR: 0.0810, p < 0.001).ConclusionThis study illustrated that among the inflammatory markers associated with aSAH prognosis, NAR could improve the SAFIRE and SAHIT models for 3 month mortality of aSAH.

OBJECTIVE: Interleukin 6 (IL-6) is an inflammatory cytokine released into the periphery after stroke, involved in the prognosis of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to explore the relationship between serum IL-6 with long-term mortality after aSAH.METHODS: We retrospectively reviewed the medical records of 18824 SAH patients for collection of serum IL-6 levels during hospitalization from a large, single-center aSAH database of Sichuan University West China Hospital. Patient deaths were determined through a national death record registration system. The primary outcome was long-term mortality. Cox regression models were used to investigate univariate and multivariate relationships between predictors and outcomes. A propensity score-matched analysis was conducted to minimize bias from confounding variables.RESULTS: In total, we included 1131 aSAH patients with 3288 records of IL-6 collections. Initial serum IL-6 values were elevated in all, ranging from 1.50 to 4522.00 pg/ml. After logarithmic transformation, the IL-6 was associated with long-term mortality (HR 1.32, 95% CI 1.21-1.44). The results maintained significant in the multivariate cox regression and propensity score-matched analysis (adjusted HR 1.23, 95% CI 1.11-1.36, p<0.001; IL-6 >103.00 pg/ml vs IL-6≤103. 00 pg/ml, PSM HR 1.94, 95% CI 1.48-2.55, p<0.001). Similar results were observed in the long-term mortality of survivors at discharge and 1-year mortality.CONCLUSIONS: Serum IL-6 is independently associated with long-term mortality of aSAH patients. Our study provided new evidence for the investigation of inflammation after aSAH and the association of inflammatory cytokines with the long-term prognosis of aSAH and might support future management decisions.