维生素D补充剂对全因死亡率的影响:随机试验重新审视
Youqing Wang1, Sha Sha2, Tafirenyika Gwenzi2
1Cancer Prevention Graduate School, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, 69115, Heidelberg, Germany; Department of Cancer Prevention, Zhejiang Cancer Hospital, 310022, Hangzhou, China.
Clinical nutrition (Edinburgh, Scotland)
|February 20, 2026
概括
补充维生素D可能会降低缺乏维生素的个体的死亡率,但不是在足够的人群中. 这项研究模拟了试验,以显示那些维生素D水平较低的人的潜在益处.
科学领域:
- 营养科学 营养科学
- 流行病学 流行病学
- 临床试验 临床试验
背景情况:
- 维生素D不足是一个全球性的健康问题,与死亡率的增加有关.
- 之前在足够的人群中进行的试验 (VITAL,D-Health) 没有显示补充剂对死亡率有好处.
- 针对缺陷群体的补充可能会改变结果.
研究的目的:
- 为了估计维生素D补充剂对维生素D不足或缺乏的人群中所有原因死亡率的影响.
- 模拟主要的随机对照试验 (VITAL,D-Health) 使用英国生物库数据.
- 根据基线血清25-基维生素-D (25(OH) D) 度分析结果.
主要方法:
- 使用英国生物银行队列数据模拟VITAL和D-Health试验.
- 对受限于维生素D不足或缺乏的人群的分析.
- 使用考克斯模型对试验随访期 (5.3-5.7年) 的死亡率影响的估计.
主要成果:
- 使用加权人群的模拟试验反映了原来的零结果 (HR 0.97-1.02).
- 限制维生素D不足人群的分析显示,死亡率显著降低 (HR 0.85-0.81).
- 限制维生素D缺乏群体的分析显示,死亡率降低更大 (HR 0.79-0.75).
结论:
- 维生素D补充剂在具有足够水平的人群中可能具有零效应.
- 在维生素D不足和缺乏的人群中,预计会显著降低死亡率.
- 仿真表明,针对性补充可能对特定子组有益.
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