钙剂补充与心血管疾病风险：临床试验的荟萃分析。
Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials.
机构信息
Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea.
Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, Goyang 10408, Korea.
出版信息
Nutrients. 2021 Jan 26;13(2):368. doi: 10.3390/nu13020368.
BACKGROUND
Recent systematic reviews and meta-analyses of randomized, double-blind, placebo-controlled trials (double-blind, placebo-controlled RCTs) have reported controversial findings regarding the associations between calcium supplements on the risk of cardiovascular disease (CVD). This meta-analysis aimed to investigate the association between them.
METHODS
We searched PubMed, EMBASE, the Cochrane Library, and the bibliographies of relevant articles for double-blind, placebo-controlled RCTs in November, 2020. Relative risks (RRs) with 95% confidence intervals (CIs) for the risk of cardiovascular disease were calculated using a random effects model. The main outcomes were CVD, coronary heart disease (CHD), and cerebrovascular disease.
RESULTS
A total of 13 double-blind, placebo-controlled RCTs ( = 28,935 participants in an intervention group and 14,243 in a control group)) were included in the final analysis. Calcium supplements significantly increased the risk of CVD (RR 1.15, 95% CI 1.06-1.25], I2 = 0.0%, = 14) and CHD (RR 1.16, 95% CI 1.05-1.28], I2 = 0.0%, = 9) in double-blind, placebo-controlled RCTs, specifically in healthy postmenopausal women. In the subgroup meta-analysis, dietary calcium intake of 700-1000 mg per day or supplementary calcium intake of 1000 mg per day significantly increased the risk of CVD and CHD.
CONCLUSIONS
The current meta-analysis found that calcium supplements increased a risk of CVD by about 15% in healthy postmenopausal women.
背景
最近对随机、双盲、安慰剂对照试验（双盲、安慰剂对照 RCT）的系统评价和荟萃分析报告了钙补充剂与心血管疾病（CVD）风险之间关联的争议性结果。本荟萃分析旨在对此进行研究。
方法
我们于 2020 年 11 月检索了 PubMed、EMBASE、Cochrane 图书馆和相关文章的参考文献，以查找双盲、安慰剂对照 RCT。使用随机效应模型计算心血管疾病风险的相对风险（RR）及其 95%置信区间（CI）。主要结局是 CVD、冠心病（CHD）和脑血管疾病。
结果
共有 13 项双盲、安慰剂对照 RCT（干预组 28935 例，对照组 14243 例）纳入最终分析。钙补充剂显著增加 CVD（RR 1.15，95%CI 1.06-1.25]，I2 = 0.0%， = 14）和 CHD（RR 1.16，95%CI 1.05-1.28]，I2 = 0.0%， = 9）的风险，特别是在健康绝经后妇女中。在亚组荟萃分析中，每天 700-1000mg 的饮食钙摄入量或每天 1000mg 的补充钙摄入量显著增加 CVD 和 CHD 的风险。
结论
目前的荟萃分析发现，钙补充剂使健康绝经后妇女 CVD 的风险增加约 15%。
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