School of Population Health, University of Auckland, Auckland, New Zealand.
Department of General Practice, University of Otago, Christchurch, New Zealand.
Am J Clin Nutr. 2019 Jun 1;109(6):1578-1587. doi: 10.1093/ajcn/nqy378.
A growing number of randomized controlled trials (RCTs) are investigating the potential health benefits of high-dose vitamin D supplementation. However, there are limited RCT data on the safety of calcium-related adverse effects.
We investigated the incidence of kidney stone and hypercalcemia events in a large, population-based RCT of vitamin D supplementation.
The Vitamin D Assessment (ViDA) study was a randomized, double-blind, placebo-controlled trial of vitamin D supplementation in 5110 participants in Auckland, New Zealand. This trial investigated the impact of monthly 100,000 IU vitamin D3 supplementation over several years on cardiovascular events, respiratory infections, and falls/fractures. Participants provided information about recent kidney stone events in regular questionnaires sent to them with study capsules. Hospitalization data for kidney stones were collected from health authorities. Serum calcium was measured in an 8% subsample of participants who returned annually for blood tests. HRs of time to the first kidney stone event were calculated by Cox regression.
During a median follow-up of 3.3 y, 158 participants reported a kidney stone event (76 vitamin D, 82 placebo). The HR of reporting the first kidney stone event was 0.90 (95% CI: 0.66, 1.23; P = 0.51) for participants in the vitamin D arm compared with the placebo arm. There were 18 urolithiasis events in the hospitalization records: 7 in the vitamin D arm and 11 from the placebo arm. The HR to the first hospitalization urolithiasis event was 0.62 (95% CI: 0.24, 1.26; P = 0.30) in the vitamin D arm compared with the placebo arm. From the subsample annual blood test, there was no case of hypercalcemia in the vitamin D arm, compared with 1 in the placebo arm.
Over a median of 3.3 y, monthly supplementation with 100,000 IU vitamin D3 did not affect the incidence rate of kidney stone events, or hypercalcemia. This study was registered at clinicaltrials.gov as ACTRN12611000402943.
越来越多的随机对照试验(RCT)正在研究大剂量维生素 D 补充剂的潜在健康益处。然而,关于钙相关不良反应安全性的 RCT 数据有限。
我们在一项大型基于人群的维生素 D 补充 RCT 中调查了肾结石和高钙血症事件的发生率。
维生素 D 评估(ViDA)研究是一项在新西兰奥克兰的 5110 名参与者中进行的维生素 D3 补充的随机、双盲、安慰剂对照试验。该试验研究了每月 100000IU 维生素 D3 补充剂在数年时间内对心血管事件、呼吸道感染和跌倒/骨折的影响。参与者在定期寄给他们的研究胶囊的问卷中提供了最近肾结石事件的信息。肾结石的住院数据从卫生当局收集。每年返回进行血液检查的 8%参与者样本中测量血清钙。通过 Cox 回归计算首次肾结石事件的时间到 HR。
在中位数为 3.3 年的随访期间,158 名参与者报告了肾结石事件(76 名维生素 D,82 名安慰剂)。与安慰剂组相比,维生素 D 组报告首次肾结石事件的 HR 为 0.90(95%CI:0.66,1.23;P=0.51)。住院记录中有 18 例尿石症事件:维生素 D 组 7 例,安慰剂组 11 例。与安慰剂组相比,维生素 D 组首次住院尿石症事件的 HR 为 0.62(95%CI:0.24,1.26;P=0.30)。从亚样本年度血液检查中,维生素 D 组没有发生高钙血症,而安慰剂组有 1 例。
在中位数为 3.3 年的时间里,每月补充 100000IU 维生素 D3 不会影响肾结石事件或高钙血症的发生率。这项研究在 clinicaltrials.gov 上注册为 ACTRN12611000402943。