Anagnostis Panagiotis, Livadas Sarantis, Goulis Dimitrios G, Rees Margaret, Lambrinoudaki Irene
Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 564 29 Thesssaloniki, Greece.
Endocrine Unit, Athens Medical Center, 151 25 Athens, Greece.
J Clin Med. 2023 Jan 24;12(3):916. doi: 10.3390/jcm12030916.
Inconsistency exists across studies conducted in postmenopausal women regarding the effect of vitamin D deficiency (VDD) and supplementation on several aspects of menopausal health, such as fractures, vasomotor symptomatology, cardiovascular disease (CVD), cancer and infections, including coronavirus disease 2019 (COVID-19). The aim of this review is to critically summarize the evidence provided by observational studies and randomized controlled trials (RCTs) of vitamin D supplementation in postmenopausal women with VDD. Observational studies have found that VDD is associated with an increased risk of falls and fractures after the menopause. VDD also has a negative effect on menopausal symptomatology. VDD, especially its severe form, is associated with an increased risk of CVD risk factors and CVD events. VDD is associated with increased risk and mortality from several cancer types and risk of infections. The evidence from RCTs regarding the effect of vitamin D supplementation on falls, fractures, menopausal symptoms, cardiovascular disease, cancer and infections is not robust. Thus, skeletal health may benefit only when vitamin D is co-administered with calcium, especially in those ≥70 years old and with severe VDD. There is no evidence of a favorable effect on menopausal symptoms or risk of CVD or cancer, except for a modest reduction in cancer-related mortality. Inconsistency still exists regarding its effect on infection risk, disease severity and mortality due to COVID-19.
在针对绝经后女性开展的研究中,关于维生素D缺乏(VDD)及其补充剂对绝经后健康多个方面的影响,如骨折、血管舒缩症状、心血管疾病(CVD)、癌症和感染(包括2019冠状病毒病(COVID-19)),存在不一致的情况。本综述的目的是批判性地总结观察性研究和随机对照试验(RCT)为VDD绝经后女性补充维生素D所提供的证据。观察性研究发现,VDD与绝经后跌倒和骨折风险增加有关。VDD对绝经症状也有负面影响。VDD,尤其是其严重形式,与CVD危险因素和CVD事件风险增加有关。VDD与几种癌症类型的风险和死亡率增加以及感染风险有关。RCT关于补充维生素D对跌倒、骨折、绝经症状、心血管疾病、癌症和感染影响的证据并不充分。因此,只有在维生素D与钙同时服用时,骨骼健康可能会受益,尤其是在那些70岁及以上且患有严重VDD的人群中。除了与癌症相关的死亡率略有降低外,没有证据表明对绝经症状或CVD或癌症风险有有利影响。关于其对感染风险、疾病严重程度和COVID-19死亡率的影响,仍然存在不一致的情况。