Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Eur J Pediatr. 2023 May;182(5):1977-1989. doi: 10.1007/s00431-023-04889-2. Epub 2023 Mar 1.
This study was designed to ascertain whether oral vitamin D supplementation (oral supplementation and fortified foods) is associated with changes in body weight measures in children and adolescents, using a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Cochrane, and Web of Science databases were searched from inception to October 28, 2022. The mean difference and corresponding 95% confidence interval (CI) of interested outcomes were pooled using a random-effects model. Twenty-one RCTs were included in the meta-analysis, and the results showed a significant decrease in body mass index (BMI) following vitamin D supplementation in children and adolescents (n = 9 studies, 1029 participants; weighted mean difference: - 0.43 kg/m, 95% CI: - 0.79, - 0.08; P = 0.02; I = 58.5%). Overall, oral vitamin D supplementation had no significant effect on body weight and other anthropometric indices, including fat mass, lean mass, waist circumference, BMI Z-score, and height. Although results of body weight changed to significant after sensitivity analysis (WMD = 0.39 kg, 95% CI = 0.01, 0.78; P = 0.04; I = 0%, P-heterogeneity = 0.71), we also found significant weight gain in healthy pediatric population, and when the dose of vitamin D supplementation was up to 600 IU/day, the certainty of evidence was very low for weight, moderate for height and BMI, and low for the remaining outcomes.
Our results suggest that vitamin D supplementation may lead to a statistically significant weight gain in children and adolescents, while BMI was reduced. Although no significant change was observed in height, it seems vitamin D supplementation may elicit these changes by increasing skeletal growth; however, this remains to be verified. Further high-quality RCTs, with longer duration and larger sample sizes, are needed to yield more certain evidence in this regard.
• Available evidence indicates an inverse association between body weight/fat mass and vitamin D status in children and adolescents; however, findings regarding the effect of vitamin D supplementation on anthropometric measurements in children are controversial.
• Our results showed a significant decrease in BMI following vitamin D supplementation in children. • A significant weight gain also was observed after sensitivity analysis, and in healthy pediatric population, and when the dose of vitamin D supplementation was up to 600 IU/day.
本研究旨在通过系统评价和荟萃分析随机对照试验(RCT),确定口服维生素 D 补充剂(口服补充剂和强化食品)是否与儿童和青少年体重指标的变化相关。
我们检索了 PubMed、Scopus、Cochrane 和 Web of Science 数据库,检索时间从建库至 2022 年 10 月 28 日。使用随机效应模型汇总了感兴趣结局的均数差值和相应的 95%置信区间(CI)。
荟萃分析纳入了 21 项 RCT,结果显示,儿童和青少年补充维生素 D 后体重指数(BMI)显著下降(n=9 项研究,1029 名参与者;加权均数差值:-0.43 kg/m,95%CI:-0.79,-0.08;P=0.02;I²=58.5%)。总体而言,口服维生素 D 补充剂对体重和其他人体测量指标(包括体脂肪量、瘦体重、腰围、BMI Z 评分和身高)没有显著影响。虽然敏感性分析后体重的结果变得有统计学意义(WMD=0.39 kg,95%CI=0.01,0.78;P=0.04;I²=0%,P 异质性=0.71),但我们也发现健康儿科人群的体重有显著增加,当维生素 D 补充剂的剂量达到 600 IU/天时,体重的证据确定性为极低,身高和 BMI 的证据确定性为中度,其余结局的证据确定性为低。
我们的结果表明,维生素 D 补充剂可能导致儿童和青少年的体重出现统计学上的显著增加,同时 BMI 降低。尽管身高没有观察到显著变化,但似乎维生素 D 补充剂可以通过增加骨骼生长来引起这些变化,但这仍有待验证。需要更多高质量的 RCT,持续时间更长,样本量更大,以在这方面提供更确定的证据。
现有证据表明,儿童和青少年的体重/体脂肪量与维生素 D 状态呈负相关;然而,关于维生素 D 补充剂对人体测量指标影响的研究结果存在争议。
我们的研究结果显示,儿童补充维生素 D 后 BMI 显著下降。经过敏感性分析后,我们还观察到体重有显著增加,在健康儿科人群中,以及当维生素 D 补充剂的剂量达到 600 IU/天时也观察到体重增加。