用维生素D补充剂预防骨折:随机对照试验的元分析
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
概括
高剂量的口服维生素D (700-800 IU/天) 有效地预防老年人部和非脊椎骨折. 较低剂量 (400 IU/d) 的维生素D不能提供足够的骨折预防益处.
科学领域:
- 老年学是指老年学的学科.
- 营养科学 营养科学
- 骨健康 骨健康 骨健康
背景情况:
- 对于预防老年人骨折的口服维生素D的最佳剂量仍然不清楚.
- 现有研究尚未确定维生素D补充剂在预防非脊椎骨折中的作用.
研究的目的:
- 确定维生素D补充剂在预防老年人部和非脊椎骨折方面的有效性.
- 为了比较不同的口服维生素D剂量对老年人骨折预防的疗效.
主要方法:
- 进行了对双盲随机对照试验 (RCT) 的系统审查和元分析.
- 在1960年至2005年间发表的研究被使用MEDLINE,Cochrane受控试验注册表和EMBASE确定.
- 纳入标准侧重于涉及老年人 (≥60岁) 接受口服维生素D (胆酸盐或酸盐) 含或不含的RCT,与安慰剂或单独相比,检查部或非脊椎骨折.
主要成果:
- 用随机效应模型进行了5项用于骨折的RCT (n=9294) 和7项用于非脊椎骨折的RCT (n=9820) 的聚合分析.
- 每日700-800 IU维生素D剂量显著降低了部骨折的相对风险 (RR) 26% (RR,0.74;95% CI,0.61-0.88) 和任何非脊椎骨折的23% (RR,0.77;95% CI,0.68-0.87).
- 每日400 IU维生素D剂量在预防骨折 (RR,1.15;95% CI,0.88-1.50) 或任何非脊椎骨折 (RR,1.03;95% CI,0.86-1.24) 方面没有显著的益处.
结论:
- 服用口服维生素D补充剂,剂量为700-800 IU/天,有效降低老年人部和非脊椎骨折的风险.
- 每日口服维生素D剂量为400 IU不足以有效预防老年人骨折.
- 这些发现支持更高剂量的维生素D补充剂用于老年人骨健康和骨折预防.
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