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钙或维生素 D 补充对血管结局的影响:随机对照试验的荟萃分析。

Effect of calcium or vitamin D supplementation on vascular outcomes: a meta-analysis of randomized controlled trials.

机构信息

Department of VIP Special Clinic, Shanghai Seventh People's Hospital, Shanghai, China.

出版信息

Int J Cardiol. 2013 Oct 30;169(2):106-11. doi: 10.1016/j.ijcard.2013.08.055. Epub 2013 Aug 27.

DOI:10.1016/j.ijcard.2013.08.055
PMID:24035175
Abstract

BACKGROUND

Whether calcium or vitamin D supplementation reduces serious vascular outcomes in older people remains unclear. We conducted a meta-analysis based on randomized controlled trials to evaluate the effect of calcium or vitamin D supplementation on the risk of major cardiovascular outcomes.

METHODS

We performed electronic searches in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials. Odds ratios (ORs) were used to measure the effect of calcium or vitamin D supplementation on the risk of major vascular outcomes with a random-effect model.

RESULTS

Of the 1643 identified studies, we included 11 trials reporting data on 50,252 individuals. These studies reported 2685 major cardiovascular events, 1097 events of myocardial infarction, and 1350 events of stroke. Calcium or vitamin D supplementation did not have an effect on major cardiovascular events (OR, 1.03; 95% confidence interval [CI]: 0.94-1.12; P=0.54), myocardial infarction (OR, 1.08; 95% CI: 0.96-1.22; P=0.21), or stroke (OR, 1.01; 95% CI: 0.91-1.13; P=0.80) when compared to the effect with a placebo. Subgroup analysis indicated that calcium supplementation alone might play an important role in increasing the risk of major cardiovascular events, myocardial infarction, and stroke, but this difference could not be identified as statistically significant. Furthermore, males seem to experience more harmful effects with supplements of calcium or vitamin D than the effects experienced by females.

CONCLUSIONS

Calcium supplementation might increase the risk of major cardiovascular events, myocardial infarction, and stroke compared to the risk with a placebo.

摘要

背景

钙或维生素 D 补充剂是否能降低老年人的严重血管事件仍不清楚。我们进行了一项基于随机对照试验的荟萃分析,以评估钙或维生素 D 补充剂对主要心血管结局风险的影响。

方法

我们在 PubMed、Embase 和 Cochrane 图书馆中进行了电子检索,以确定相关的随机对照试验。使用随机效应模型,用优势比(OR)来衡量钙或维生素 D 补充剂对主要血管结局风险的影响。

结果

在 1643 项已确定的研究中,我们纳入了 11 项报告了 50252 名个体数据的试验。这些研究报告了 2685 例主要心血管事件、1097 例心肌梗死事件和 1350 例中风事件。与安慰剂相比,钙或维生素 D 补充剂对主要心血管事件(OR,1.03;95%置信区间[CI]:0.94-1.12;P=0.54)、心肌梗死(OR,1.08;95% CI:0.96-1.22;P=0.21)或中风(OR,1.01;95% CI:0.91-1.13;P=0.80)没有影响。亚组分析表明,单独补充钙可能会增加主要心血管事件、心肌梗死和中风的风险,但这种差异没有统计学意义。此外,男性似乎比女性更容易受到钙或维生素 D 补充剂的不良影响。

结论

与安慰剂相比,钙补充剂可能会增加主要心血管事件、心肌梗死和中风的风险。

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