Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, North West Province, South Africa.
Nutr Rev. 2024 Apr 12;82(5):579-599. doi: 10.1093/nutrit/nuad082.
Vitamin D plays an important role in immune function, and the deficiency thereof has been associated with several infections, most notably respiratory tract infections. However, data from intervention studies investigating the effect of high-dose vitamin D supplementation on infections have been inconclusive.
The aim of this study was to evaluate the level of evidence regarding the efficacy of vitamin D supplementation above the standard dose (400 IU) in preventing infections in apparently healthy children < 5 years of age.
PubMed, Scopus, Science Direct, Web of Science, Google Scholar, CINAHL, and MEDLINE electronic databases were searched between August 2022 and November 2022. Seven studies met the inclusion criteria.
Meta-analyses of outcomes in more than one study were performed using Review Manager software. Heterogeneity was evaluated using the I2 statistic. Randomized controlled trials in which vitamin D was supplemented at > 400 IU compared with placebo, no treatment, or standard dose were included.
Seven trials that enrolled a total of 5748 children were included. Odds ratios (ORs) with 95%CIs were calculated using random- and fixed-effects models. There was no significant effect of high-dose vitamin D supplementation on the incidence of upper respiratory tract infection (OR, 0.83; 95%CI, 0.62-1.10). There was a 57% (95%CI, 0.30-0.61), 56% (95%CI, 0.27-0.07), and 59% (95%CI, 0.26-0.65) reduction in the odds of influenza/cold, cough, and fever incidence, respectively, with daily supplementation of vitamin D > 1000 IU. No effect was found on bronchitis, otitis media, diarrhea/gastroenteritis, primary care visits for infections, hospitalizations, or mortality.
High-dose vitamin D supplementation provided no benefit in preventing upper respiratory tract infections (moderate certainty of evidence) but reduced the incidence influenza/cold (moderate certainty of evidence), cough, and fever (low certainty of evidence). These findings are based on a limited number of trials and should be interpreted with caution. Further research is needed.
PROSPERO registration number CRD42022355206.
维生素 D 在免疫功能中起着重要作用，其缺乏与多种感染有关，尤其是呼吸道感染。然而，关于大剂量维生素 D 补充剂对感染影响的干预研究的数据尚无定论。
本研究旨在评估大剂量（400IU 以上）维生素 D 补充剂预防<5 岁健康儿童感染的疗效证据水平。
2022 年 8 月至 11 月期间，检索了 PubMed、Scopus、Science Direct、Web of Science、Google Scholar、CINAHL 和 MEDLINE 电子数据库。有 7 项研究符合纳入标准。
使用 Review Manager 软件对多项研究的结果进行荟萃分析。使用 I2 统计评估异质性。纳入了维生素 D 补充剂剂量>400IU 与安慰剂、无治疗或标准剂量比较的随机对照试验。
共纳入 7 项试验，总计 5748 名儿童。使用随机和固定效应模型计算优势比（OR）及其 95%置信区间。大剂量维生素 D 补充剂对上呼吸道感染发生率无显著影响（OR，0.83；95%CI，0.62-1.10）。每日补充维生素 D>1000IU 可使流感/感冒、咳嗽和发热的发病几率分别降低 57%（95%CI，0.30-0.61）、56%（95%CI，0.27-0.07）和 59%（95%CI，0.26-0.65）。但对支气管炎、中耳炎、腹泻/肠胃炎、因感染就诊的初级保健、住院或死亡率无影响。
大剂量维生素 D 补充剂对预防上呼吸道感染无益处（证据质量为中等），但可降低流感/感冒（证据质量为中等）、咳嗽和发热（证据质量为低）的发生率。这些发现基于有限数量的试验，应谨慎解读。需要进一步研究。
PROSPERO 注册号 CRD42022355206。
