Vitamin D and Calcium Supplementation Reverses Tenofovir-Caused Bone Mineral Density Loss in People Taking ART or PrEP: A Systematic Review and Meta-Analysis.
Vitamin D and Calcium Supplementation Reverses Tenofovir-Caused Bone Mineral Density Loss in People Taking ART or PrEP: A Systematic Review and Meta-Analysis.
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维生素 D 和钙补充剂可逆转接受 ART 或 PrEP 的患者因替诺福韦引起的骨矿物质密度损失：系统评价和荟萃分析
DOI：
10.3389/fnut.2022.749948
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发表时间：
2022
影响因子：
5
通讯作者：
Xu, Junjie
中科院分区：
文献类型：
--
作者：
Bi, Xiaoyan;Liu, Fan;Zhang, Xiangjun;Wang, Hongyi;Ye, Zehao;Yun, Ke;Huang, Xiaojie;Ding, Haibo;Geng, Wenqing;Xu, Junjie
在暴露前预防（PrEP）方案下，艾滋病毒/艾滋病（PLWHA）感染者和艾滋病毒阴性关键人群摄入基于替诺福韦酯富马酸盐（TDF）的药物后骨密度（BMD）下降引起了关注。以前的研究结果的影响，维生素D（VD）和钙补充剂和恢复骨密度损失是不确定的。VD和钙剂的最佳剂量和补充时间尚不清楚。因此，我们进行了一项系统性综述和荟萃分析，以综合目前关于VD和钙补充剂的证据，为临床实践提供信息。我们在PubMed、Web of Science、科克伦图书馆和EMBASE数据库中检索了2021年3月5日之前发表的所有安慰剂对照试验和前瞻性队列研究，这些研究调查了服用基于TDP药物的参与者的VD和钙补充剂。使用关键词钙、维生素D、替诺福韦和BMD进行检索。主要观察指标为脊柱和髋部骨密度的变化。进行亚组分析，以确定与VD补充剂对BMD影响相关的因素。局部加权回归（黄土）被用来确定VD补充，补充时间，和BMD的变化的关系。本研究在PROSPERO注册（编号42021231000）。7项合格研究（包括703例受试者）纳入分析。荟萃分析发现，VD和钙补充与脊柱和髋关节BMD显著增加相关[标准化平均差异（SMD）0.43; 95%CI，0.25至0.61，p = 0.009]。此外，VD和钙补充剂的剂量、补充时间和BMD恢复之间存在正剂量-反应关系。服用剂量水平为4，000 IU/D的VD的患者获得了最高的BMD改善（SMD 0.59，95% CI，0.43至0.74）。未报告VD和钙补充剂的副作用。我们发现VD和钙补充剂与服用基于TDP的药物的参与者的BMD增加相关。建议临床医生对VD的最佳补充剂量为4，000 IU/D。这些发现可用于临床实践，以改善服用基于TDF的药物的人的BMD结果。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/。
The decrease of bone mineral density (BMD) after the intake of Tenofovir disoproxil fumarate (TDF)-based drugs in people living with HIV/AIDS (PLWHA) and HIV-negative key populations under pre-exposure prophylaxis (PrEP) regimen raised concerns. Previous findings on the effects of vitamin D (VD) and calcium supplements and the recovery of BMD loss were inconclusive. The optimal doses of VD and calcium and its supplementary duration remained unknown. Therefore, we conducted a systematic review and meta-analysis to synthesize current evidence on VD and calcium supplements to inform clinical practice. We searched PubMed, Web of Science, Cochrane library, and EMBASE databases for all placebo-controlled trials and prospective cohort studies published before March 5, 2021 that investigated VD and calcium supplements in participants taking TDF-based drugs. The keywords calcium, vitamin D, Tenofovir, and BMD were used for the searches. The primary outcome was changes of spine and hip BMD. A subgroup analysis was performed to determine the factors that were related to the effects of VD supplements on BMD. Locally weighted regression (loess) was used to determine the relationships of VD supplements, supplementary duration, and changes of BMD. This study was registered at PROSPERO (No. 42021231000). Seven eligible studies including 703 participants were included in the analyses. The meta-analysis found that VD and calcium supplementation was related to a significant increase of BMD in the spine and hip [standardized mean difference (SMD) 0.43; 95% CI, 0.25 to 0.61, p = 0.009]. Moreover, positive dose-response relationships were demonstrated between doses of VD and calcium supplements, supplementary duration, and BMD recovery. Patients who took VD with the dose level of 4,000 IU/D obtained the highest BMD improvement (SMD 0.59, 95% CI, 0.43 to 0.74). No side effects were reported on VD and calcium supplementation. We found the VD and calcium supplementation was associated with increases of BMD in participants taking TDF-based drugs. An optimal supplementary dose of 4,000 IU/D for VD was suggested for clinicians. The findings could be used in clinical practice to improve the BMD outcomes in people who were taking TDF-based drugs. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/.
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影响因子：
5.4
作者：
Fields SD;Tung E
通讯作者：
Tung E
DOI：
10.1007/s00198-020-05584-w
发表时间：
2021-02
期刊：
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
影响因子：
--
作者：
通讯作者：
--
影响因子：
2.2
作者：
Manosuthi W;Ongwandee S;Bhakeecheep S;Leechawengwongs M;Ruxrungtham K;Phanuphak P;Hiransuthikul N;Ratanasuwan W;Chetchotisakd P;Tantisiriwat W;Kiertiburanakul S;Avihingsanon A;Sukkul A;Anekthananon T;Adults and Adolescents Committee of the Thai National HIV Guidelines Working Group
通讯作者：
Adults and Adolescents Committee of the Thai National HIV Guidelines Working Group
影响因子：
8.4
作者：
Cressey, Tim R.;Siriprakaisil, Oraphan;Drain, Paul K.
通讯作者：
Drain, Paul K.
影响因子：
--
作者：
Mela, Quirico;Ruggiero, Valeria;Chessa, Luchino
通讯作者：
Chessa, Luchino