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一项关于维生素 D 对维生素 D 不足的老年女性肌肉力量和活动能力影响的随机对照试验。

A randomized controlled trial of the effects of vitamin D on muscle strength and mobility in older women with vitamin D insufficiency.

机构信息

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.

出版信息

J Am Geriatr Soc. 2010 Nov;58(11):2063-8. doi: 10.1111/j.1532-5415.2010.03142.x.

Abstract

OBJECTIVES

To evaluate the effects of vitamin D treatment on muscle strength and mobility in older women with vitamin D insufficiency.

DESIGN

One-year population-based, double-blind, randomized, controlled trial.

SETTING

Perth, Australia (latitude 32°S).

PARTICIPANTS

Three hundred two community-dwelling ambulant elderly women aged 70 to 90 with a serum 25-hydroxyvitamin D (25(OH)D) concentration less than 24 ng/mL.

INTERVENTION

Vitamin D(2) 1,000 IU/d or identical placebo; calcium citrate (1 g calcium/d) in both groups.

MEASUREMENTS

Lower limb muscle strength and mobility as assessed using the Timed Up and Go Test (TUAG).

RESULTS

At baseline, mean ± standard deviation serum 25(OH)D was 17.7 ± 4.2 ng/mL; this increased to 24.0 ± 5.6 ng/mL in the vitamin D group after 1 year but remained the same in the placebo group. For hip extensor and adductor strength and TUAG, but not for other muscle groups, a significant interaction between treatment group and baseline values was noted. In those with baseline values in the lowest tertile, vitamin D improved muscle strength and TUAG more than calcium alone (mean (standard error): hip extensors 22.6% (9.5%); hip adductors 13.5% (6.7%), TUAG 17.5% (7.6%), P < .05). Baseline 25(OH)D levels did not influence patient response to supplementation.

CONCLUSION

Vitamin D therapy was observed to increase muscle function in those who were the weakest and slowest at baseline. Vitamin D should be given to people with insufficiency or deficiency to improve muscle strength and mobility.

摘要

目的

评估维生素 D 治疗对维生素 D 不足的老年女性肌肉力量和活动能力的影响。

设计

为期 1 年的基于人群的、双盲、随机、对照试验。

地点

澳大利亚珀斯(纬度 32°S)。

参与者

302 名居住在社区、能走动的 70 至 90 岁的老年女性,血清 25-羟维生素 D(25(OH)D)浓度<24ng/mL。

干预措施

维生素 D(2)1000IU/d 或相同的安慰剂;两组均服用柠檬酸钙(1g 钙/d)。

测量

使用计时起立行走测试(Timed Up and Go Test,TUAG)评估下肢肌肉力量和活动能力。

结果

基线时,平均±标准差血清 25(OH)D 为 17.7±4.2ng/mL;1 年后,维生素 D 组增至 24.0±5.6ng/mL,但安慰剂组不变。对于臀伸肌和内收肌力量以及 TUAG,但不是其他肌肉群,治疗组与基线值之间存在显著的交互作用。在基线值处于最低三分位数的患者中,维生素 D 对肌肉力量和 TUAG 的改善比单独补钙更明显(均值(标准误差):臀伸肌 22.6%(9.5%);臀内收肌 13.5%(6.7%),TUAG 17.5%(7.6%),P<.05)。基线 25(OH)D 水平不影响患者对补充剂的反应。

结论

维生素 D 治疗观察到在基线时最弱和最慢的患者中增加肌肉功能。应向维生素 D 不足或缺乏的人补充维生素 D,以改善肌肉力量和活动能力。

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