维生素 D 补充对一般和中心性肥胖的影响：来自涉及明显健康人群的 20 项随机对照试验的结果。

Effects of Vitamin D Supplementation on General and Central Obesity: Results from 20 Randomized Controlled Trials Involving Apparently Healthy Populations.

机构信息

Department of Medical Services, Zhengzhou Central Hospital affiliated to Zhengzhou University, Zhengzhou, China.

Public Health and Preventive Medicine Teaching and Research Center, Henan University of Chinese Medicine, Zhengzhou, China,

出版信息

Ann Nutr Metab. 2020;76(3):153-164. doi: 10.1159/000507418. Epub 2020 Jul 9.

DOI:10.1159/000507418

PMID:32645694

Abstract

BACKGROUND

The obesity pandemic has been paralleled by a high prevalence of vitamin D deficiency (VDD). There is growing epidemiological evidence linking low vitamin D status with obesity events. In addition, observational studies also show that obesity may increase the risk of VDD. However, there is insufficient knowledge to understand whether there is a causality between the two. Moreover, the impact of vitamin D supplementation on obesity indices has shown inconsistent outcomes.

OBJECTIVE

This meta-analysis aimed to assess whether vitamin D supplementation modified general and central obesity indices in apparently healthy populations.

METHODS

A systematic retrieval of relevant randomized controlled trials (RCTs) was undertaken using Pubmed, Embase, Web of Knowledge and Chinese National Knowledge Infrastructure databases. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were used to assess the changes in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and 25-hydroxyvitamin D (25[OH]D) from baseline.

RESULTS

Twenty RCTs involving 3,153 participants reporting either BMI, WC, WHR or 25(OH)D met the inclusion criteria. When compared with placebo, vitamin D supplementation had no significant decreases in BMI (WMD = -0.09 kg/m2, 95% CI -0.19 to 0.01, p = 0.08), WC (WMD = -0.71 cm, 95% CI -1.58 to 0.16, p = 0.112) or WHR (WMD = 0.00, 95% CI -0.01 to 0.01, p = 0.749). However, in the subgroups of females, Asia region studies and intervention duration ≥6 months, a beneficial and significant reduction in BMI and WC was noted (all p < 0.026). On the other hand, pooled results showed that there was a significant increase in serum 25(OH)D levels (WMD = 13.20 ng/mL, 95% CI 9.83-16.58, p < 0.001) after vitamin D intervention. No publication bias was found in our study.

CONCLUSIONS

Overall, supplementation with vitamin D produced no significant effect on the BMI, WC or WHR of healthy adults.

摘要

背景

肥胖症的流行与维生素 D 缺乏症（VDD）的高发率并存。越来越多的流行病学证据表明，维生素 D 水平低与肥胖事件有关。此外，观察性研究还表明，肥胖可能会增加 VDD 的风险。但是，人们对两者之间是否存在因果关系还知之甚少。此外，维生素 D 补充对肥胖指数的影响结果不一致。

目的

本荟萃分析旨在评估维生素 D 补充剂是否会改变表型健康人群的总体和中心肥胖指数。

方法

使用 Pubmed、Embase、Web of Knowledge 和中国国家知识基础设施数据库对相关的随机对照试验（RCT）进行系统检索。使用加权均数差（WMD）和 95％置信区间（CI）来评估从基线开始时体重指数（BMI）、腰围（WC）、腰臀比（WHR）和 25-羟维生素 D（25[OH]D）的变化。

结果

有 20 项 RCT 符合纳入标准，共涉及 3153 名报告 BMI、WC、WHR 或 25（OH）D 的参与者。与安慰剂相比，维生素 D 补充剂对 BMI（WMD=-0.09 kg/m2，95％CI-0.19 至 0.01，p=0.08）、WC（WMD=-0.71 cm，95％CI-1.58 至 0.16，p=0.112）或 WHR（WMD=0.00，95％CI-0.01 至 0.01，p=0.749）没有明显降低。但是，在女性亚组、亚洲地区研究和干预持续时间≥6 个月的亚组中，BMI 和 WC 有明显降低（均 p＜0.026）。另一方面，汇总结果显示，维生素 D 干预后血清 25（OH）D 水平显著升高（WMD=13.20 ng/mL，95％CI 9.83-16.58，p＜0.001）。我们的研究未发现发表偏倚。