维生素 K 和钙对人体骨密度的联合作用：随机对照试验的荟萃分析。
The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials.
机构信息
Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road 16369, Jinan, 250014, China.
出版信息
J Orthop Surg Res. 2021 Oct 14;16(1):592. doi: 10.1186/s13018-021-02728-4.
BACKGROUND
With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. We conducted a systematic review of randomized controlled trials to assess the effect of this combination treatment on BMD and UcOC in humans.
METHODS
A search for articles was conducted using PubMed, Embase, and the Cochrane Library database up to March 2021 (no language restrictions). We also reviewed the reference lists of the relevant publications and reviews to locate additional publications. The standard mean difference (SMD) was used as the primary measure of effect size. Our main endpoints were lumbar BMD, femoral neck BMD, hip BMD, total femoral BMD, and UcOC from baseline to end point. We performed subgroup analysis, heterogeneity testing, and assessment of publication bias.
RESULTS
A total of 1346 patients from 10 randomized controlled trials were included in the meta-analysis. The forest plot analysis revealed that vitamin K combined with calcium was associated with a higher lumbar spine BMD compared to controls. The SMD was 0.20 [95% confidence interval (CI): 0.07 to 0.32]. Vitamin K and calcium supplementation led to a significant decrease in UcOC (SMD: - 1.71, 95% CI: - 2.45 to - 0.96). Subgroup analysis showed that vitamin K2 and vitamin K1 had SMDs of 0.30 (95% CI: 0.10 to 0.51) and SMDs of 0.14 (95% CI: - 0.02 to 0.29), and calcium dosages of ≤ 1000 mg/d or > 1000 mg/d had SMDs of 0.19 (95% CI: 0.05 to 0.32) and 0.26 (95% CI: - 0.04 to 0.55).
CONCLUSION
The combination of vitamin K and calcium has a positive effect on lumbar BMD and decreases the level of UcOC. Registration: The protocol for this meta-analysis was registered at the International Prospective Register of Systematic Reviews (CRD42021251825).
背景
随着骨质疏松症发病率的增加，许多研究都将维生素 K 和钙与骨矿物质密度（BMD）和非羧化骨钙素（UcOC）联系起来，但关于维生素 K 和钙联合作用对人体 BMD 和 UcOC 的研究结果并不一致。我们进行了一项系统评价，以评估这种联合治疗对人体 BMD 和 UcOC 的影响。
方法
使用 PubMed、Embase 和 Cochrane 图书馆数据库对截至 2021 年 3 月的文章进行了检索（无语言限制）。我们还查阅了相关出版物和综述的参考文献列表，以确定其他出版物。标准均数差（SMD）被用作主要的效应量测量指标。我们的主要终点是从基线到终点的腰椎 BMD、股骨颈 BMD、髋部 BMD、总股骨 BMD 和 UcOC。我们进行了亚组分析、异质性检验和发表偏倚评估。
结果
共有来自 10 项随机对照试验的 1346 名患者纳入了荟萃分析。森林图分析显示，与对照组相比，维生素 K 联合钙治疗与腰椎 BMD 升高相关。SMD 为 0.20[95%置信区间（CI）：0.07-0.32]。维生素 K 和钙补充剂导致 UcOC 显著下降（SMD：-1.71，95%CI：-2.45 至-0.96）。亚组分析显示，维生素 K2 和维生素 K1 的 SMD 分别为 0.30（95%CI：0.10-0.51）和 0.14（95%CI：-0.02-0.29），钙剂量为≤1000mg/d 或>1000mg/d 的 SMD 分别为 0.19（95%CI：0.05-0.32）和 0.26（95%CI：-0.04-0.55）。
结论
维生素 K 和钙联合使用对腰椎 BMD 有积极影响，并降低 UcOC 水平。注册：本荟萃分析的方案在国际前瞻性系统评价注册库（CRD42021251825）进行了注册。
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