Institute of Clinical Medicine, University of Tromsø, University Hospital of North Norway, Tromsø, Norway.
Nutr J. 2010 Jan 7;9:1. doi: 10.1186/1475-2891-9-1.
In meta-analyses supplementation with vitamin D appears to reduce incidence of fractures, and in cross-sectional studies there is a positive association between serum 25-hydroxyvitamin D (25(OH)D) levels and bone mineral density (BMD). However, the effect of supplementation with high doses of vitamin D on BMD is more uncertain and could in theory have both positive and negative effects.
The study was a one year, double blind placebo-controlled intervention trial performed at the University Hospital of North Norway. 421 subjects, 21 - 70 years old, were included and 312 completed the study. The subjects were randomized to vitamin D3 40.000 IU per week (DD group), vitamin D3 20.000 IU per week (DP group), or placebo (PP group). All subjects were given 500 mg calcium daily. Serum 25(OH)D, osteoprotegrin (OPG), receptoractivator of nuclear factor-kappaB ligand (RANKL), and BMD at the lumbar spine and the hip were measured before and at the end of the study.
At baseline the mean serum 25(OH)D levels were 58 nmol/L (all subjects) and increased to 141 and 100 nmol/L in the DD and DP groups, respectively. After one year, no significant differences were found between the three groups regarding change in BMD, serum OPG or RANKL.
Supplementation with high doses of vitamin D for one year does not appear to have a negative effect on BMD in healthy subjects. In order to disclose a positive effect, subjects with low BMD and/or low serum 25(OH)D levels need to be studied.
The trial was registered at ClinicalTrials.gov (NCT00243256).
荟萃分析显示,维生素 D 补充剂可降低骨折发生率,而在横断面研究中,血清 25-羟维生素 D(25(OH)D)水平与骨密度(BMD)呈正相关。然而,高剂量维生素 D 补充对 BMD 的影响尚不确定,从理论上讲可能既有积极影响也有消极影响。
该研究是在挪威北大学医院进行的为期一年、双盲、安慰剂对照干预试验。共纳入 421 名年龄在 21-70 岁的受试者,其中 312 名完成了研究。受试者被随机分为每周接受维生素 D3 40,000 IU(DD 组)、每周接受维生素 D3 20,000 IU(DP 组)或安慰剂(PP 组)。所有受试者每日接受 500 mg 钙。在研究开始前和结束时测量血清 25(OH)D、骨保护素(OPG)、核因子-κB 受体激活剂配体(RANKL)和腰椎及髋部 BMD。
基线时,所有受试者的平均血清 25(OH)D 水平为 58 nmol/L,DD 组和 DP 组分别增加至 141 和 100 nmol/L。一年后,三组间 BMD、血清 OPG 或 RANKL 的变化均无显著差异。
补充高剂量维生素 D 一年似乎不会对健康受试者的 BMD 产生负面影响。为了揭示积极影响,需要研究 BMD 和/或血清 25(OH)D 水平较低的受试者。
该试验在 ClinicalTrials.gov 注册(NCT00243256)。