Zheng Ya Ting, Cui Qi Qi, Hong Yi Min, Yao Wei Guang
College of Humanities and Management, Southern Medical University, Guangzhou, Guangdong Province, China.
PLoS One. 2015 Jan 20;10(1):e0115850. doi: 10.1371/journal.pone.0115850. eCollection 2015.
The effects of intermittent, high dose vitamin D treatment in older adults have not been documented. We conducted a meta-analysis to provide a quantitative assessment of the efficiency of intermittent, high dose vitamin D treatment on falls, fractures, and mortality among older adults.
Electronic databases were searched for randomized controlled trials (RCTs) on high dose, intermittent vitamin D supplementation among older adults. Two researchers independently screened the literature according to specified inclusive and exclusive criteria to extract the data. Meta-analysis was performed by using Review Manager 5.1.0 software.
Nine trials were included in this meta-analysis. High dose, intermittent vitamin D therapy did not decrease all-cause mortality among older adults. The risk ratio (95% CI) was 1.04 (0.91-1.17). No benefit was seen in fracture or fall prevention. The risk ratio for hip fractures (95% CI) was 1.17 (0.97-1.41) while for non-vertebral fractures (95% CI) it was 1.06 (0.91-1.22), and the risk ratio for falls (95% CI) was 1.02 (0.96-1.08). Results remained robust after sensitivity analysis.
Supplementation of intermittent, high dose vitamin D may not be effective in preventing overall mortality, fractures, or falls among older adults. The route of administration of vitamin D supplements may well change the physiological effects.
间歇高剂量维生素D治疗对老年人的影响尚无文献记载。我们进行了一项荟萃分析，以定量评估间歇高剂量维生素D治疗对老年人跌倒、骨折和死亡率的有效性。
检索电子数据库，查找关于老年人高剂量间歇补充维生素D的随机对照试验（RCT）。两名研究人员根据指定的纳入和排除标准独立筛选文献以提取数据。使用Review Manager 5.1.0软件进行荟萃分析。
本荟萃分析纳入了9项试验。高剂量间歇维生素D治疗并未降低老年人的全因死亡率。风险比（95%可信区间）为1.04（0.91 - 1.17）。在预防骨折或跌倒方面未发现益处。髋部骨折的风险比（95%可信区间）为1.17（0.97 - 1.41），非椎体骨折的风险比（95%可信区间）为1.06（0.91 - 1.22），跌倒的风险比（95%可信区间）为1.02（0.96 - 1.08）。敏感性分析后结果依然稳健。
间歇补充高剂量维生素D可能对预防老年人的总体死亡率、骨折或跌倒无效。维生素D补充剂的给药途径很可能会改变其生理效应。
