Department of Family Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea.
Hospice Palliative Medicine, Division of Spirituality, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea.
BMC Geriatr. 2018 Sep 4;18(1):206. doi: 10.1186/s12877-018-0904-2.
Vitamin D deficiency and frailty are common with aging. Previous studies examining vitamin D status and frailty have produced mixed results, and in particular, the shape of the association has not been well established. We examined the association between 25-hydroxyvitamin D (25OHD) serum levels and frailty by performing a systematic review and dose-response meta-analysis.
We searched the PubMed, EMBASE and Cochrane Library databases of Elsevier through February 2017. Cross-sectional and cohort studies that reported adjusted risk ratios with 95% confidence intervals (CI) for frailty with ≥3 categories of 25OHD serum levels were selected. Data extraction was performed independently by two authors. The reported risk estimates for 25OHD categories were recalculated, employing a comprehensive trend estimation from summarized dose-response data.
The pooled risk estimate of frailty syndrome per 25 nmol/L increment in serum 25OHD concentration was 0.88 (95% CI = 0.82-0.95, I = 86.8%) in the 6 cross-sectional studies and 0.89 (95% CI = 0.85-0.94, I = 0.0%) in the 4 prospective cohort studies. Based on the Akaike information criteria (AIC), a linear model was selected (AIC for the nonlinear model: - 5.4, AIC for the linear model: - 6.8 in the prospective cohort studies; AIC for the linear model: - 13.6, AIC for the nonlinear model: - 1.77 in the cross-sectional studies).
This dose-response meta-analysis indicates that serum 25OHD levels are significantly and directly associated with the risk of frailty. Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome.
维生素 D 缺乏和衰弱与衰老有关。之前研究维生素 D 状态与衰弱的结果存在差异，特别是两者之间的关系尚未明确。我们通过系统综述和剂量反应荟萃分析来研究 25-羟维生素 D（25OHD）血清水平与衰弱之间的关系。
我们检索了 Elsevier 的 PubMed、EMBASE 和 Cochrane Library 数据库，检索时间截至 2017 年 2 月。选择了报告了衰弱症与 25OHD 血清水平≥3 个分类的调整后风险比及其 95%置信区间（95%CI）的横断面和队列研究。由两位作者独立进行数据提取。使用综合剂量反应数据的全面趋势估计值，重新计算了报告的 25OHD 类别风险估计值。
在 6 项横断面研究中，血清 25OHD 浓度每增加 25nmol/L，衰弱综合征的合并风险估计值为 0.88（95%CI=0.82-0.95，I=86.8%），在 4 项前瞻性队列研究中，合并风险估计值为 0.89（95%CI=0.85-0.94，I=0.0%）。基于赤池信息量准则（AIC），选择了线性模型（前瞻性队列研究中非线性模型的 AIC 为-5.4，线性模型的 AIC 为-6.8；横断面研究中线性模型的 AIC 为-13.6，非线性模型的 AIC 为-1.77）。
该剂量反应荟萃分析表明，血清 25OHD 水平与衰弱的风险显著且直接相关。需要进一步的研究来阐明这种关系的潜在机制，并确定维生素 D 补充是否有效预防衰弱综合征。
