U.S. Preventive Services Task Force, Rockville, Maryland, USA.
Ann Intern Med. 2013 May 7;158(9):691-6. doi: 10.7326/0003-4819-158-9-201305070-00603.
New U.S. Preventive Services Task Force (USPSTF) recommendation statement on vitamin D and calcium supplementation to prevent fractures in adults.
The USPSTF commissioned 2 systematic evidence reviews and a meta-analysis on vitamin D supplementation with or without calcium to assess the effects of supplementation on bone health outcomes in community-dwelling adults, the association of vitamin D and calcium levels with bone health outcomes, and the adverse effects of supplementation.
These recommendations apply to noninstitutionalized or community-dwelling asymptomatic adults without a history of fractures. This recommendation does not apply to the treatment of persons with osteoporosis or vitamin D deficiency.
The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women or in men. (I statement)The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with greater than 400 IU of vitamin D3 and greater than 1000 mg of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women. (I statement)The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D3 and 1000 mg or less of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women. (D recommendation).
美国预防服务工作组（USPSTF）关于维生素 D 和钙补充剂预防成年人骨折的新推荐声明。
USPSTF委托进行了 2 项系统证据审查和荟萃分析，评估了维生素 D 补充剂（含或不含钙）对社区居住的成年人骨骼健康结局的影响、维生素 D 和钙水平与骨骼健康结局的关联，以及补充剂的不良反应。
这些建议适用于没有骨折史的非住院或社区居住的无症状成年人。本建议不适用于骨质疏松症或维生素 D 缺乏症患者的治疗。
USPSTF 得出结论，目前的证据不足以评估联合使用维生素 D 和钙补充剂预防绝经前妇女或男性骨折的利弊平衡。（I 级声明）USPSTF 得出结论，目前的证据不足以评估每天补充超过 400IU 的维生素 D3 和超过 1000mg 的钙对预防非住院绝经后妇女骨折的利弊平衡。（I 级声明）USPSTF 建议非住院绝经后妇女不要每天补充 400IU 或更少的维生素 D3 和 1000mg 或更少的钙来预防骨折。（D 级推荐）
