Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation.
Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation.
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DOI：
10.1007/s00198-015-3386-5
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
Wang DD
中科院分区：
文献类型：
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作者：
Weaver CM;Alexander DD;Boushey CJ;Dawson-Hughes B;Lappe JM;LeBoff MS;Liu S;Looker AC;Wallace TC;Wang DD
其目的是对钙加维生素D补充剂和骨折预防的随机对照试验进行荟萃分析。Meta分析显示，总体骨折风险显著降低15%(汇总相对风险估计[SRRE]，0.85；95%可信区间[CI]，0.73-0.98)，髋部骨折风险降低30%(SRRE，0.70；95%CI，0.56-0.87)。钙加维生素D补充剂被广泛推荐用于预防骨质疏松症和随后的骨折；然而，关于这种补充剂与骨折风险之间的关联仍存在相当大的争议。其目的是在成人中进行钙加维生素D补充和预防骨折的随机对照试验[RCT]的荟萃分析。对2011年7月1日至2015年7月31日期间的PubMed文献进行了检索。报道钙加维生素D补充对骨折发生率影响的随机对照试验选自英文研究。提取定性和定量信息；进行随机效应荟萃分析，生成全髋部骨折和髋部骨折的汇总相对风险估计(SRRE)。使用Cochran‘s Q检验和I2统计量评估统计异质性，并评估潜在的发表偏倚。在检索到的引文中，8项研究(包括30,970名参与者)符合纳入初步分析的标准，报告了195处髋部骨折和2231处骨折。对所有研究的荟萃分析表明，补充钙和维生素D产生了具有统计学意义的15%的总体骨折风险降低(SRRE，0.85；95%可信区间[CI]，0.73-0.98)和30%的髋部骨折风险降低(SRRE，0.70；95%可信区间，0.56-0.87)。大量的敏感性分析和分组分析产生了类似的概要关联。一个限制是，这项研究利用了妇女健康倡议小组分析的数据。这项随机对照试验的荟萃分析支持使用钙和维生素D补充剂作为一种干预措施，在社区居民和住院的中老年人中降低骨折风险。
The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87). Calcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults. A PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran’s Q test and the I2 statistic, and potential for publication bias was assessed. Of the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women’s Health Initiative. This meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.