Mooijaart Simon P, Dekkers Olaf M, Van den Bos Frederiek
Leids Universitair Medisch Centrum, Leiden, hoofdafd. Interne Geneeskunde, sub-afd. Ouderengeneeskunde.
Contact: Simon P. Mooijaart (
Ned Tijdschr Geneeskd. 2023 Mar 16;167:D7176.
Vitamin D supplementation has been suggested for many diseases and symptoms that are frequent in older people: loss of bone mineral density, falls, loss of muscle mass, infections (including COVID-19) and mortality. In observational studies, vitamin D concentration has been associated with many poor outcomes, but in most Randomized Controlled Trials, there is no beneficial effect of vitamin D supplementation on these outcomes, except for bone mineral density. An alternative explanation of the observed association may be 'confounding': older people with poor mobility have lower vitamin D, and irrespective of that also have poor outcomes. The recent COVIT-TRIAL seems to suggest there is benefit of high dose vitamin D supplementation compared to low dose on mortality in older people with COVID-19, but on closer methodological look this conclusion does not hold. Clinical guidelines rightly do not advise vitamin D supplementation for a whole range of diseases, including COVID-19.
对于老年人常见的许多疾病和症状，如骨矿物质密度降低、跌倒、肌肉量减少、感染（包括新冠病毒感染）及死亡率等，有人建议补充维生素D。在观察性研究中，维生素D浓度与许多不良后果相关，但在大多数随机对照试验中，除了骨矿物质密度外，补充维生素D对这些后果并无有益影响。对所观察到的关联的另一种解释可能是“混杂因素”：行动不便的老年人维生素D水平较低，且无论维生素D水平如何，他们的预后也较差。最近的COVID-TRIAL研究似乎表明，与低剂量相比，高剂量补充维生素D对感染新冠病毒的老年人的死亡率有益，但仔细审视其方法后，这一结论并不成立。临床指南正确地不建议对包括新冠病毒感染在内的一系列疾病补充维生素D。
