ビタミンDサプリメントによる骨折予防:ランダム化対照試験のメタ解析
Heike A Bischoff-Ferrari1, Walter C Willett, John B Wong
1Department of Nutrition, Harvard School of Public Health, Boston, Mass 02115, USA. hbischof@hsph.harvard.edu
JAMA
|May 12, 2005
まとめ
口から摂取するビタミンDの高用量 (700~800 IU/日) は,高齢者における股関節および非脊椎骨折を効果的に予防します. 低用量 (400 IU/日) のビタミンDは,骨折の予防に十分な効果を提供していません.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 栄養科学とは,栄養科学である.
- 骨の健康 骨の健康とは
背景:
- 高齢者の骨折を予防するための口服用ビタミンDの最適な用量は不明である.
- 既存の研究は,非脊椎骨折の予防におけるビタミンDサプリメントの役割を明確に確立していない.
研究 の 目的:
- 高齢者の間でヒップと非脊椎骨折を予防するビタミンDサプリメントの有効性を決定する.
- 高齢者の骨折予防のための異なる口服用ビタミンD用量の有効性を比較する.
主な方法:
- ダブルブラインドランダム化対照試験 (RCT) の体系的レビューとメタ解析が行われました.
- 1960年から2005年の間に発表された研究は,MEDLINE,コクレーン統制試験レジスタ,EMBASEを用いて特定されました.
- 含有基準は,口服ビタミンD (コレカルシフェロールまたはエルゴカルシフェロール) をカルシウムと併用または併用せず,プラセボまたはカルシウムのみと比較して,高齢者 (≥60歳) を対象としたRCTに焦点を当て,部または非脊椎骨折を調査したRCTでした.
主要な成果:
- 股関節骨折のための5つのRCT (n=9294) と非脊椎骨折のための7つのRCT (n=9820) のプール分析は,ランダム効果モデルを使用して行われました.
- 700~800 IUのビタミンDを1日1回投与すると,股関節骨折の相対リスク (RR) が26% (RR,0.74;95%CI,0.61-0.88) と,非脊椎骨折の相対リスクは23% (RR,0.77;95%CI,0.68-0.87) と著しく低下しました.
- ビタミンDの1日用量400IUは,股関節骨折 (RR,1.15;95%CI,0.88-1.50) や非脊椎骨折 (RR,1.03;95%CI,0.86-1.24) の予防に有意な効果を示さなかった.
結論:
- 700〜800IU/dの口服ビタミンDサプリメントは,高齢者における股関節および非脊椎骨折のリスクを低減するのに有効です.
- 毎日口服で摂取する400IUのビタミンDは,高齢者の骨折を効果的に予防するには不十分です.
- これらの発見は,高齢者の骨の健康と骨折の予防のために,より高用量のビタミンDのサプリメントを推奨しています.
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