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维生素 D 不足的老年女性患者的肌肉力量和活动能力:一项关于维生素 D 和钙补充的随机对照试验。

Muscle strength and mobility in vitamin D-insufficient female geriatric patients: a randomized controlled trial on vitamin D and calcium supplementation.

机构信息

Department of Geriatric Medicine, University Medical Centre Utrecht, 3508 GA Utrecht, The Netherlands.

出版信息

Aging Clin Exp Res. 2010 Feb;22(1):78-84. doi: 10.1007/BF03324819.

Abstract

BACKGROUND AND AIMS

Insufficient vitamin D status, commonly found in older people, has been associated with muscle weakness which, in old age, impairs mobility and is a risk factor for falling. In a randomized, double-blind placebo-controlled trial, we tested the hypothesis that vitamin D + calcium supplementation improves muscle strength and mobility, compared with calcium mono-therapy in vitamin D-insufficient female geriatric patients.

METHODS

Seventy female geriatric patients >65 years of age with serum 25-hydroxyvitamin D3 (25OHD) concentrations between 20 and 50 nmol/L, visiting an outpatient geriatric department, were included. Participants received either cholecalciferol 400 IU/day + calcium 500 mg/day (D/Cal group) or a placebo + calcium 500 mg/day (Plac/Cal group) for 6 months. At baseline and 6 months, muscle strength, power and functional mobility were tested.

RESULTS

At baseline, 25OHD was significantly (p<0.05) associated with knee extension strength (r=0.42), handgrip strength (r=0.28), leg extension power (r=0.34), Timed Get Up and Go (r=-0.31) and Modified Cooper test (r=0.44). At 6 months, a significant difference in 25OHD (77.2 vs 41.6 nmol/L, p<0.001) and 1,25OHD was found between the two groups. Significantly improving vitamin D status in the D/Cal group compared with the Plac/Cal group did not result in a significant difference in strength or functional mobility between the two groups.

CONCLUSIONS

Daily 400 IU vitamin D + 500 mg calcium supplementation is not enough to significantly improve strength or mobility in vitamin D-insufficient female geriatric patients.

摘要

背景与目的

老年人中常见的维生素 D 不足与肌肉无力有关,而肌肉无力会影响老年人的活动能力,是导致跌倒的危险因素。在一项随机、双盲、安慰剂对照试验中,我们测试了这样一个假设,即与单独补钙相比,维生素 D 和钙联合补充可改善维生素 D 不足的老年女性患者的肌肉力量和活动能力。

方法

70 名年龄在 65 岁以上、血清 25-羟维生素 D3(25OHD)浓度在 20 至 50 nmol/L 之间的老年女性患者被纳入该研究。患者被随机分配接受胆钙化醇 400 IU/天+钙 500 mg/天(D/Cal 组)或安慰剂+钙 500 mg/天(Plac/Cal 组)治疗,为期 6 个月。在基线和 6 个月时,测试了肌肉力量、功率和功能性活动能力。

结果

在基线时,25OHD 与膝关节伸展力量(r=0.42)、手握力(r=0.28)、腿伸展功率(r=0.34)、计时起立行走测试(r=-0.31)和改良库珀测试(r=0.44)显著相关(p<0.05)。在 6 个月时,两组间 25OHD(77.2 与 41.6 nmol/L,p<0.001)和 1,25OHD 差异有统计学意义。与 Plac/Cal 组相比,D/Cal 组的维生素 D 状态显著改善,但两组间的力量或功能性活动能力差异无统计学意义。

结论

每天补充 400 IU 维生素 D 和 500 mg 钙不足以显著改善维生素 D 不足的老年女性患者的力量或活动能力。

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