Division of Geriatric Medicine, Department of Medicine, Parkwood Hospital, University of Western Ontario, London, Ontario, Canada.
J Am Geriatr Soc. 2011 Dec;59(12):2291-300. doi: 10.1111/j.1532-5415.2011.03733.x.
To systematically review and quantitatively synthesize the effect of vitamin D supplementation on muscle strength, gait, and balance in older adults.
Systematic review and meta-analysis.
MEDLINE, EMBASE, Cochrane Library, bibliographies of selected articles, and previous systematic reviews were searched between January 1980 and November 2010 for eligible articles.
Older adults (≥60) participating in randomized controlled trials of the effect of supplemental vitamin D without an exercise intervention on muscle strength, gait, and balance.
Data were independently extracted, and study quality was evaluated. Meta-analysis using a fixed-effects model was performed and the I(2) statistic was used to assess heterogeneity.
Of 714 potentially relevant articles, 13 met the inclusion criteria. In the pooled analysis, vitamin D supplementation yielded a standardized mean difference of -0.20 (95% confidence interval (CI) = -0.39 to -0.01, P = .04, I(2) = 0%) for reduced postural sway, -0.19 (95% CI = -0.35 to -0.02, P = .03, I(2) = 0%) for decreased time to complete the Timed Up and Go Test, and 0.05 (95% CI = -0.11 to 0.20, P = .04, I(2) = 0%) for lower extremity strength gain. Regarding dosing frequency regimen, only one study demonstrated a beneficial effect on balance with a single large dose. All studies with daily doses of 800 IU or more demonstrated beneficial effects on balance and muscle strength.
Supplemental vitamin D with daily doses of 800 to 1,000 IU consistently demonstrated beneficial effects on strength and balance. An effect on gait was not demonstrated, although further evaluation is recommended.
系统回顾和定量综合维生素 D 补充对老年人肌肉力量、步态和平衡的影响。
系统回顾和荟萃分析。
检索 MEDLINE、EMBASE、Cochrane 图书馆、选定文章的参考文献和以前的系统评价，以确定 1980 年 1 月至 2010 年 11 月期间维生素 D 补充对肌肉力量、步态和平衡无运动干预作用的随机对照试验。
参加维生素 D 补充剂对肌肉力量、步态和平衡影响的随机对照试验的老年人（≥60 岁），且未进行运动干预。
独立提取数据并评估研究质量。采用固定效应模型进行荟萃分析，并使用 I²统计量评估异质性。
在 714 篇潜在相关文章中，有 13 篇符合纳入标准。在汇总分析中，维生素 D 补充的标准化均数差值为 -0.20（95%置信区间 [CI] = -0.39 至 -0.01，P = 0.04，I² = 0%），用于减少姿势摆动；-0.19（95% CI = -0.35 至 -0.02，P = 0.03，I² = 0%），用于缩短完成计时起立行走测试的时间；0.05（95% CI = -0.11 至 0.20，P = 0.04，I² = 0%），用于下肢力量增加。关于给药频率方案，只有一项研究表明单次大剂量对平衡有有益影响。所有每天给予 800 IU 或更多剂量的研究均表明对平衡和肌肉力量有有益影响。
每天给予 800 至 1000 IU 的维生素 D 补充剂可一致改善力量和平衡。虽然建议进一步评估，但对步态的影响并未显示。
