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维生素D补充剂及其对社区居住老年人肌肉力量和活动能力的影响:一项系统评价和荟萃分析。

Vitamin D supplementation and its influence on muscle strength and mobility in community-dwelling older persons: a systematic review and meta-analysis.

作者信息

Rosendahl-Riise H, Spielau U, Ranhoff A H, Gudbrandsen O A, Dierkes J

机构信息

Department of Clinical Science, University of Bergen, Bergen, Norway.

Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Halle, Germany.

出版信息

J Hum Nutr Diet. 2017 Feb;30(1):3-15. doi: 10.1111/jhn.12394. Epub 2016 Jul 27.

Abstract

BACKGROUND

It has been suggested that vitamin D status or supplementation is important for maintaining or improving muscle strength and mobility in older adults. The study results, however, do not provide consistent results. We therefore aimed to summarise the available evidence systematically, including only studies conducted in community-dwelling older persons.

METHODS

A systematic search of the literature was performed in April of 2016. The systematic review includes studies that used vitamin D with or without calcium supplementation as the exposure variable and various measurements of muscle strength and mobility. The meta-analysis was limited to studies using hand grip strength (HGS) and timed-up-and-go test as the outcome variables.

RESULTS

A total of 15 studies out of 2408 articles from the literature search were included in the systematic review, providing 2866 participants above the age of 65 years. In the majority of studies, no improvement in muscle strength and mobility was observed after administration of vitamin D with or without calcium supplements. In the meta-analysis, we observed a nonsignificant change in HGS [+0.2 kg (95% confidence interval = -0.25 to 0.7 kg; seven studies)] and a small, significant increase in the timed-up-and-go test [0.3 s (95% confidence interval = 0.1 to 0.5 s; five studies)] after vitamin D supplementation. The meta-analyses showed a high degree of heterogeneity between the studies.

CONCLUSIONS

In conclusion, we observed no improvement in muscle strength after the administration of vitamin D with or without calcium supplements. We did find a small but significant deterioration of mobility. However, this is based on a limited number of studies and participants.

摘要

背景

有人提出,维生素D状态或补充剂对于维持或改善老年人的肌肉力量和活动能力很重要。然而,研究结果并不一致。因此,我们旨在系统地总结现有证据,仅纳入针对社区居住老年人开展的研究。

方法

2016年4月对文献进行了系统检索。该系统评价纳入了以补充维生素D(无论是否补充钙)作为暴露变量以及各种肌肉力量和活动能力测量指标的研究。荟萃分析仅限于使用握力(HGS)和计时起立行走测试作为结局变量的研究。

结果

文献检索得到的2408篇文章中,共有15项研究纳入系统评价,提供了2866名65岁以上的参与者。在大多数研究中,补充维生素D(无论是否补充钙)后,未观察到肌肉力量和活动能力有所改善。在荟萃分析中,我们观察到补充维生素D后,握力无显著变化[增加0.2千克(95%置信区间=-0.25至0.7千克;7项研究)],计时起立行走测试有小幅显著增加[0.3秒(95%置信区间=0.1至0.5秒;5项研究)]。荟萃分析显示各研究之间存在高度异质性。

结论

总之,我们观察到补充维生素D(无论是否补充钙)后肌肉力量没有改善。我们确实发现活动能力有小幅但显著的下降。然而,这是基于数量有限的研究和参与者得出的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5248635/a989db21937d/JHN-30-3-g001.jpg

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