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钙补充剂与心血管疾病和中风风险的关联:系统评价和荟萃分析。

Association Between Calcium Supplementation and the Risk of Cardiovascular Disease and Stroke: A Systematic Review and Meta-Analysis.

机构信息

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: http://www.twitter.com/yaoneng_teo.

出版信息

Heart Lung Circ. 2023 Oct;32(10):1230-1239. doi: 10.1016/j.hlc.2023.07.008. Epub 2023 Sep 23.

Abstract

BACKGROUND

Some observational studies and randomised controlled trials (RCTs) have reported an association between calcium supplementation and increased risk of cardiovascular disease. Previous meta-analyses on the topic, based on data from RCTs and observational studies, have contradictory findings. This meta-analysis was conducted to determine the difference in associated risks of calcium supplementation with cardiovascular disease and stroke in RCTs.

METHODS

Relevant studies published from database inception to 6 August 2021 were sourced from PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials. Any RCTs focusing on the relationship between calcium supplementation and incidence of cardiovascular disease or stroke were included. Articles were screened independently by two authors, according to the PICO criteria, with disagreements resolved by a third author.

RESULTS

Twelve RCTs were included in the meta-analysis. Calcium supplementation was not associated with myocardial infarction, total stroke, heart failure admission, and all-cause/cardiovascular mortality. Subgroup analysis focusing on calcium monotherapy/calcium co-therapy with vitamin D, female sex, follow-up duration, and geographical region did not affect the findings.

CONCLUSION

Calcium supplementation was not associated with myocardial infarction, total stroke, heart failure admission, and cardiovascular/all-cause mortality. Further studies are required to examine and understand these associations.

摘要

背景

一些观察性研究和随机对照试验(RCT)报告称,钙补充剂与心血管疾病风险增加之间存在关联。此前基于 RCT 和观察性研究数据的关于该主题的荟萃分析得出的结论存在矛盾。本荟萃分析旨在确定 RCT 中钙补充与心血管疾病和卒中相关风险的差异。

方法

从数据库建立到 2021 年 8 月 6 日,从 PubMed、Embase、Scopus 和 Cochrane 对照试验中心注册库中检索到相关研究。纳入了任何专注于钙补充与心血管疾病或卒中发生率之间关系的 RCT。根据 PICO 标准,由两位作者独立筛选文章,如有分歧,则由第三位作者解决。

结果

荟萃分析纳入了 12 项 RCT。钙补充与心肌梗死、总卒中、心力衰竭入院和全因/心血管死亡率无关。亚组分析集中在钙单药/钙与维生素 D 联合治疗、女性、随访时间和地理区域上,并未影响研究结果。

结论

钙补充与心肌梗死、总卒中、心力衰竭入院和心血管/全因死亡率无关。需要进一步研究来检查和理解这些关联。

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