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对频繁呼吸道感染患者补充维生素D:一项随机安慰剂对照试验的事后分析

Vitamin D supplementation to patients with frequent respiratory tract infections: a post hoc analysis of a randomized and placebo-controlled trial.

作者信息

Bergman Peter, Norlin Anna-Carin, Hansen Susanne, Björkhem-Bergman Linda

机构信息

Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden.

Division of Clincal Immunology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden.

出版信息

BMC Res Notes. 2015 Aug 30;8:391. doi: 10.1186/s13104-015-1378-3.

Abstract

BACKGROUND

Vitamin D is considered to be important for a healthy immune system. The aim of this study was to test the hypothesis that vitamin D supplementation reduces number of respiratory tract infections (RTIs) and prolong the time to the first RTI in adult patients with frequent RTIs.

METHODS

We performed a post hoc analysis of a randomized, placebo-controlled and double-blinded study, where adult patients with a high burden of RTIs were randomized to placebo or vitamin D (4000 IE/day for 1 year, n = 124 in the per protocol cohort presented here).

RESULTS

Vitamin D supplementation increased the probability to stay free of RTI during the study year (RR 0.64, 95% CI 0.43-0.94). Further, the total number of RTIs was also reduced in the vitamin D-group (86 RTIs) versus placebo (120 RTIs; p = 0.05). Finally, the time to the first RTI was significantly extended in the vitamin D-group (HR 1.68, 95% CI 1.03-2.68, p = 0.0376).

CONCLUSION

Vitamin D supplementation was found to significantly increase the probability of staying infection free during the study period. This finding further supports the notion that vitamin D-status should be monitored in adult patients with frequent RTIs and suggests that selected patients with vitamin D deficiency are supplemented. This could be a safe and cheap way to reduce RTIs and improve health in this vulnerable patient population. The original trial was registered at http://www.clinicaltrials.gov (NCT01131858).

摘要

背景

维生素D被认为对健康的免疫系统很重要。本研究的目的是检验以下假设:补充维生素D可减少成年频繁呼吸道感染(RTI)患者的呼吸道感染次数,并延长首次发生RTI的时间。

方法

我们对一项随机、安慰剂对照和双盲研究进行了事后分析,将RTI负担高的成年患者随机分为安慰剂组或维生素D组(每天4000国际单位,持续1年,此处按方案队列中有124例)。

结果

补充维生素D增加了研究年度内无RTI的概率(风险比0.64,95%置信区间0.43 - 0.94)。此外,维生素D组的RTI总数也低于安慰剂组(86次RTI对120次RTI;p = 0.05)。最后,维生素D组首次发生RTI的时间显著延长(风险比1.68,95%置信区间1.03 - 2.68,p = 0.0376)。

结论

研究发现补充维生素D可显著增加研究期间无感染的概率。这一发现进一步支持了应对成年频繁RTI患者监测维生素D状态的观点,并建议对选定的维生素D缺乏患者进行补充。这可能是减少RTI并改善这一脆弱患者群体健康的一种安全且廉价的方法。原始试验已在http://www.clinicaltrials.gov(NCT01131858)注册。

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