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高剂量维生素D补充剂对体积骨密度和骨强度的影响:随机临床试验
Lauren A Burt1, Emma O Billington1, Marianne S Rose2
1McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
JAMA
|August 28, 2019
概括
在健康的成年人中,高剂量维生素D补充剂 (每天4000 IU或10,000 IU) 没有改善骨矿物质密度 (BMD) 或强度. 与每日400 IU剂量相比,更高的剂量与辐射和骨骨质量下降有关.
科学领域:
- 内分泌学
- 骨质新陈代谢
- 营养科学
背景情况:
- 只有少数研究研究了维生素D剂量达到或超过可容忍的上限的长期影响.
- 美国大约3%的成年人每天摄入4000 IU或更多的维生素D.
研究的目的:
- 评估维生素D补充剂对体积骨矿物密度 (BMD) 和骨强度的剂量依赖作用.
主要方法:
- 这是一项为期三年的双盲随机临床试验,涉及311名年龄在55-70岁之间的健康成年人.
- 参与者每天服用400 IU,4000 IU或10,000 IU的维生素D3.
- 使用高分辨率的外围定量计算断层扫描和有限元分析来评估骨矿物质密度和强度.
主要成果:
- 与400 IU组相比,更高的维生素D剂量 (4000 IU和10,000 IU) 导致辐射体积 BMD 的统计显著下降.
- 与400IU剂量相比,10,000IU剂量显著降低了部体积 BMD.
- 在半径或骨之间没有观察到骨强度 (失败负荷) 的显著差异.
结论:
- 在健康的成年人中,每天服用4000 IU或10,000 IU的维生素D补充剂并没有对骨健康产生好处.
- 结果表明高剂量维生素D可能没有益处, 需要进一步调查潜在的危害.
- 这些结果不支持在这个人群中常规使用高剂量的维生素D来改善骨健康.
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