Wu Haiting, Pang Qingjiang
Department of Spine Surgery, Ningbo No. 2 Hospital, 315010, Ningbo, Zhejiang, China.
Department of Orthopaedics Center, Ningbo No. 2 Hospital, 315010, Ningbo, Zhejiang, China.
Orthopade. 2017 Sep;46(9):729-736. doi: 10.1007/s00132-017-3446-y.
A number of studies have hypothesized that vitamin D is a potential factor in the prevention of falls in the elderly; however, the effect of vitamin D is still inconsistent and not quantitative. We conducted this meta-analysis to assess the effect of vitamin D on falls among elderly individuals.
The PubMed and Cochrane Library databases were searched from the earliest possible year up to December 2016. Two authors working independently reviewed the trials, and odds ratios (ORs) were calculated using a fixed-effect or random-effect model by Review Manager 5.3. We included only double-blind randomized, controlled trials (RCTs) of vitamin D in elderly populations that examined fall results.
A total of 26 articles were included in which 16,540 elderly individuals received vitamin D supplementation, while 16,146 were assigned to control groups. The meta-analysis showed that combined vitamin D plus calcium supplementation has a significant effect on the reduction in the risk of falls (OR for the risk of suffering at least one fall, 0.87; 95% CI, 0.80-0.94). However, no significant association between vitamin D2 or D3 and a reduction in the risk of falls was found (OR, 0.77; 95% CI, 0.58-1.03 for vitamin D2, and OR, 1.08; 95% CI, 0.98-1.20 for vitamin D3).
Combined calcium plus vitamin D supplementation is statistically significantly associated with a reduction in fall risks across various populations.
多项研究推测维生素D是预防老年人跌倒的一个潜在因素;然而,维生素D的效果仍不一致且无法量化。我们进行了这项荟萃分析,以评估维生素D对老年个体跌倒的影响。
检索了PubMed和Cochrane图书馆数据库,时间跨度从最早年份至2016年12月。两名作者独立审查试验,并使用Review Manager 5.3软件通过固定效应或随机效应模型计算比值比(OR)。我们仅纳入了针对老年人群的维生素D双盲随机对照试验(RCT),这些试验对跌倒结果进行了检测。
共纳入26篇文章,其中16540名老年人接受了维生素D补充,而16146名被分配到对照组。荟萃分析表明,维生素D联合钙剂补充对降低跌倒风险有显著效果(至少发生一次跌倒风险的OR为0.87;95%置信区间为0.80 - 0.94)。然而,未发现维生素D2或D3与跌倒风险降低之间存在显著关联(维生素D2的OR为0.77;95%置信区间为0.58 - 1.03,维生素D3的OR为1.08;95%置信区间为0.98 - 1.20)。
钙加维生素D联合补充在统计学上与不同人群跌倒风险的降低显著相关。