Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis.
Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis.
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DOI：
10.1111/j.1532-5415.2010.02949.x
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发表时间：
2010-07
影响因子：
6.3
通讯作者：
Crews DC
中科院分区：
文献类型：
--
作者：
Kalyani RR;Stein B;Valiyil R;Manno R;Maynard JW;Crews DC
系统回顾和定量综合维生素D治疗对老年人跌倒预防的作用。系统回顾和荟萃分析.检索MEDLINE、CINAHL、Web of Science、EMBASE、科克伦图书馆、LILACS、所选文献的参考书目以及截至2009年2月的既往系统评价，以寻找符合条件的研究。参加了随机对照试验的老年人（年龄≥60岁），这些试验研究了维生素D治疗预防福尔斯的有效性，并使用了明确的跌倒定义。两位作者独立提取了数据，包括研究特征、质量评估和结局。I2统计量用于评估随机效应模型中的异质性。在1，679篇潜在相关文章中，10项研究符合纳入标准。在汇总分析中，与钙或安慰剂相比，维生素D治疗（200- 1000 IU）使福尔斯减少14%（相对风险[RR] 0.86;95%置信区间0.79-0.93;I2=7%）;需要治疗的人数=15。以下亚组的跌倒发生率显著降低：居住在社区（年龄<80岁）、坚持补钙、无骨折/福尔斯史、持续时间>6个月、胆钙化醇和剂量≥800 IU。荟萃回归分析表明，维生素D剂量或持续时间与治疗效果无线性相关性。事后分析，包括7个额外的研究（共17个）没有明确的跌倒定义，产生了较小的益处（RR 0.92，0.87 -0.98）和更多的异质性（I2=36%），但发现组间差异显著，有利于补充钙与不补充钙（p=0.001）。维生素D治疗可有效降低老年人福尔斯跌倒的风险。未来的研究应该调查特定人群或治疗方案是否可能有更大的益处。
To systematically review and quantitatively synthesize the effect of vitamin D therapy on fall prevention in older adults. Systematic review and meta-analysis. MEDLINE, CINAHL,Web of Science, EMBASE, Cochrane Library, LILACS, bibliographies of selected articles, and previous systematic reviews through February 2009 were searched for eligible studies. Older adults (aged ≥60 years) who participated in randomized controlled trials that investigated the effectiveness of vitamin D therapy in the prevention of falls and used an explicit fall definition. Two authors independently extracted data including study characteristics, quality assessment, and outcomes. The I2 statistic was used to assess heterogeneity in a randomeffects model. Of 1,679 potentially relevant articles, 10 studies met inclusion criteria. In pooled analysis, vitamin D therapy (200-1000IU) reduced falls by 14% (relative risk [RR] 0.86;95% confidence interval 0.79-0.93;I2=7%) compared to calcium or placebo; number needed to treat=15. The following subgroups had significant fall reductions: community-dwelling (age<80 years), adjunctive calcium supplementation, no history of fractures/falls, duration>6 months, cholecalciferol, and dose≥800 IU. Meta-regression demonstrated no linear association of vitamin D dose or duration with treatment effect. Post-hoc analysis, including 7 additional studies (17 total) without explicit fall definitions, yielded smaller benefit (RR 0.92,0.87-0.98) and more heterogeneity (I2=36%) but found significant intergroup differences favoring adjunctive calcium versus none (p=0.001). Vitamin D treatment effectively reduces the risk of falls in older adults. Future studies should investigate whether particular populations or treatment regimens may have greater benefit.
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影响因子：
4.3
作者：
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通讯作者：
Holick, Michael F
影响因子：
6.7
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Conzelmann, M
DOI：
10.1111/j.1532-5415.2007.01048.x
发表时间：
2007-02-01
影响因子：
6.3
作者：
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通讯作者：
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