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减重手术后维生素 D 补充预防维生素 D 缺乏症的系统评价和荟萃分析。

Vitamin D supplementation for the prevention of vitamin D deficiency after bariatric surgery: a systematic review and meta-analysis.

机构信息

Department of General Surgery, Peking University Third Hospital, Beijing, China.

出版信息

Eur J Clin Nutr. 2018 Aug;72(8):1061-1070. doi: 10.1038/s41430-017-0059-9. Epub 2017 Dec 29.

DOI:10.1038/s41430-017-0059-9
PMID:29288249
Abstract

OBJECTIVE

To evaluate the efficacy of vitamin D supplementation on the prevention of postoperative vitamin D deficiency.

METHODS

PubMed, Embase, Web of Science, and Cochrane library were searched. Prospective studies evaluating the effects of vitamin D supplementation in patients who had undergone bariatric surgery were included. Meta-regression was performed to explore heterogeneity, and assess the relationship between dosage of vitamin D supplementation, study design, and prevalence of vitamin D depletion.

RESULTS

Twelve studies enrolling 1285 patients met the inclusion criteria, and were included. Vitamin D supplementation was associated with significant improvements in 1-year Vitamin D depletion and 1-year 25-OHD level. A daily supplement of more than 800 IU vitamin D significantly reduced the prevalence of 1-year Vitamin D depletion, but the dosage of less than 800 IU did not. Significant decrease in prevalence of 1-year Vitamin D depletion was observed in randomized controlled trials (RCTs), but not in non-RCTs. For the 1-year 25-OHD level, significant elevation was found in the studies irrespective of the study design and dosage of vitamin D supplementation. Meta-regression showed that there was significant relationship between vitamin D depletion and study design, but not between vitamin D depletion and the dosage of vitamin D supplementation.

CONCLUSION

Vitamin D supplementation with a daily dosage of more than 800 IU is effective in preventing postoperative vitamin D deficiency and improving the 25-OHD level. However, the results should be interpreted cautiously since there was significant heterogeneity among the studies.

摘要

目的

评估维生素 D 补充剂在预防术后维生素 D 缺乏症方面的疗效。

方法

检索 PubMed、Embase、Web of Science 和 Cochrane 图书馆。纳入评估维生素 D 补充剂对接受减重手术患者影响的前瞻性研究。进行荟萃回归分析以探索异质性,并评估维生素 D 补充剂量、研究设计与维生素 D 耗竭发生率之间的关系。

结果

共纳入 12 项纳入 1285 例患者的研究。维生素 D 补充与 1 年维生素 D 耗竭和 1 年 25-羟维生素 D 水平的显著改善相关。每天补充超过 800IU 的维生素 D 可显著降低 1 年维生素 D 耗竭的发生率,但补充剂量低于 800IU 则没有。随机对照试验(RCT)中观察到 1 年维生素 D 耗竭发生率显著降低,但非 RCT 中则没有。对于 1 年 25-羟维生素 D 水平,无论研究设计和维生素 D 补充剂量如何,均观察到显著升高。荟萃回归显示,维生素 D 耗竭与研究设计之间存在显著关系,但与维生素 D 补充剂量之间则没有。

结论

每天补充超过 800IU 的维生素 D 可有效预防术后维生素 D 缺乏症并提高 25-羟维生素 D 水平。然而,由于研究间存在显著异质性,因此结果应谨慎解释。

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