维生素B和骨健康:对随机对照试验的试验顺序分析的元分析
Yan Luo1,2,3, Shengyuan Zheng1,2,3, Shide Jiang4
1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
概括
维生素B补充剂 (叶酸,B6,B12) 并没有显著降低骨折发生率或改善骨矿物质密度. 需要更多的研究来证实对骨循环标记物的影响.
科学领域:
- 营养科学 营养科学
- 骨健康研究 骨健康研究
- 临床试验 临床试验
背景情况:
- 骨质疏松症是一个重大的全球健康挑战,增加骨折风险.
- 维生素B (叶酸,B6,B12) 正在研究它们对骨健康的潜在作用.
- 目前对维生素B对骨代谢的影响的研究是有限的.
研究的目的:
- 评估B族维生素 (VB) 补充剂对骨折发生率的疗效.
- 评估VBs对骨矿物质密度 (BMD) 的影响.
- 为了确定VBs对骨循环标记 (BTMs) 的影响.
主要方法:
- 在主要数据库 (PubMed,MEDLINE,EMBASE,Cochrane,ClinicalTrials.gov) 中进行全面的文献搜索.
- 使用Cochrane手册评估偏见风险,使用GRADE系统评估证据质量.
- 随机错误,敏感性和出版偏差分析的试验顺序分析 (TSA).
主要成果:
- 对14项涉及34,700名患者的RCT进行分析.
- VBs没有显著降低骨折发生率 (RR,1.06;p=0.33) 或影响BMD.
- VBs对骨形成标志物没有显著影响,但增加了骨再吸收标志物 (p=0.009). 交通安全局证实了骨折发生率的充分证据,但指出了BMD和BTMs的有限数据.
结论:
- 目前来自RCT的证据不支持使用维生素B来影响骨质疏松性骨折风险.
- 维生素B对BMD和BTM的影响需要通过更多的临床试验进一步调查.
- 该研究强调,需要继续研究骨健康的营养干预措施.
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