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维生素 D 补充对膝骨关节炎的影响:随机对照试验的荟萃分析。

The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials.

机构信息

Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.

Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.

出版信息

Int J Surg. 2017 Oct;46:14-20. doi: 10.1016/j.ijsu.2017.08.010. Epub 2017 Aug 7.

DOI:10.1016/j.ijsu.2017.08.010
PMID:28797917
Abstract

OBJECTIVE

We conducted a meta-analysis of RCTs to evaluate the effects of vitamin D supplementation in the prevention of symptom and structural progression of knee OA.

METHODS

PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Outcomes included Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, stiffness, tibial cartilage volume, and serum vitamin D3 levels, and adverse events. Results were expressed as weight mean difference (WMD) with 95% confidence interval (CI), and risk ratio (RR) with 95%CI.

RESULTS

Four RCTs involving 1136 patients were included in this study. Pooled estimates suggested that vitamin D supplementation was associated with a significant reduction in WOMAC pain, and WOMAC function, but not in WOMAC stiffness. Vitamin D supplementation increased the serum vitamin D3 level, but had no effect on tibial cartilage volume. Subgroup analysis showed that, a daily supplement of more than 2000 IU vitamin D significantly decreased the WOMAC pain and WOMAC function. There was no significant difference in incidence of adverse events between the vitamin D and placebo groups.

CONCLUSION

Vitamin D supplementation was effective in improving the WOMAC pain and function in patients with knee OA. However, it had no beneficial effect on the prevention of tibial cartilage loss. Therefore, there is currently a lack of evidence to support the use of vitamin D supplementation in preventing the progression of knee OA.

摘要

目的

我们进行了一项随机对照试验的荟萃分析,以评估维生素 D 补充剂在预防膝关节骨关节炎症状和结构进展方面的效果。

方法

我们检索了 PubMed、Embase 和 Web of Science 数据库,以确定相关研究。结局指标包括西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)疼痛、功能、僵硬、胫骨软骨体积和血清维生素 D3 水平以及不良反应。结果表示为加权均数差(WMD)及其 95%置信区间(CI),风险比(RR)及其 95%CI。

结果

本研究纳入了四项涉及 1136 名患者的随机对照试验。汇总估计表明,维生素 D 补充与 WOMAC 疼痛和 WOMAC 功能的显著降低相关,但与 WOMAC 僵硬无关。维生素 D 补充增加了血清维生素 D3 水平,但对胫骨软骨体积没有影响。亚组分析表明,每天补充超过 2000IU 的维生素 D 可显著降低 WOMAC 疼痛和 WOMAC 功能。维生素 D 组与安慰剂组之间的不良反应发生率无显著差异。

结论

维生素 D 补充在改善膝关节骨关节炎患者的 WOMAC 疼痛和功能方面是有效的。然而,它对预防胫骨软骨丢失没有有益的影响。因此,目前缺乏支持维生素 D 补充用于预防膝关节骨关节炎进展的证据。

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