Chou Sharon H, Cook Nancy R, Kotler Gregory, Kim Eunjung, Copeland Trisha, Lee I Min, Cawthon Peggy M, Buring Julie E, Manson JoAnn E, LeBoff Meryl S
Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2024 Dec 18;110(1):e44-e53. doi: 10.1210/clinem/dgae150.
Declining muscle strength and performance in older adults are associated with falls, fractures, and premature death.
This work aimed to determine whether supplementation with vitamin D3 or omega-3 fatty acids vs placebo for 2 years improves physical performance measures.
VITamin D and OmegA-3 TriaL (VITAL) was a double-blinded, placebo-controlled randomized trial of supplemental vitamin D3 and/or omega-3 fatty acids vs placebo in the prevention of cancer and cardiovascular disease in 25 871 US adults. This ancillary study was completed in a New England subcohort that had in-person evaluations at baseline and 2-year follow-up. This study was conducted with 1054 participants (age: men ≥50 and women ≥55 years) at the Center for Clinical Investigations in Boston. Interventions included a 2 × 2 factorial design of supplemental vitamin D3 (cholecalciferol, 2000 IU/day) and/or marine omega-3 fatty acids (1 g/day). Main outcome measures included 2-year changes in physical performance measures of grip strength, walking speed, standing balance, repeated chair stands, and Timed-up and Go (TUG).
At 2 years, all randomized groups showed worsening walking speeds and TUG. There were no differences in changes in grip strength, walking speeds, Short Physical Performance Battery (composite of walking speed, balance, and chair stands), and TUG between the vitamin D3-treated and the placebo-treated groups and between the omega-3-treated and the placebo-treated groups. Effects overall did not vary by sex, age, body mass index, or baseline measures of total or free 25-hydroxyvitamin D (25[OH]D) or plasma omega-3 index; TUG slightly worsened with vitamin D supplementation, compared to placebo, in participants with baseline total 25(OH)D levels above the median (P = .01; P for interaction = .04).
Neither supplemental vitamin D3 nor marine omega-3 fatty acids for 2 years improved physical performance in this generally healthy adult population.
老年人肌肉力量和功能下降与跌倒、骨折及过早死亡相关。
本研究旨在确定补充维生素D3或ω-3脂肪酸2年，相较于安慰剂，是否能改善身体功能指标。
维生素D和ω-3试验（VITAL）是一项在美国25871名成年人中进行的双盲、安慰剂对照的随机试验，比较补充维生素D3和/或ω-3脂肪酸与安慰剂在预防癌症和心血管疾病方面的效果。这项辅助研究在新英格兰的一个亚组中完成，该亚组在基线和2年随访时进行了面对面评估。本研究在波士顿临床研究中心对1054名参与者（年龄：男性≥50岁，女性≥55岁）进行。干预措施包括2×2析因设计的补充维生素D3（胆钙化醇，2000 IU/天）和/或海洋ω-3脂肪酸（1g/天）。主要结局指标包括握力、步行速度、站立平衡、重复起坐以及计时起立行走测试（TUG）等身体功能指标在2年时的变化。
2年后，所有随机分组的组步行速度和TUG均变差。维生素D3治疗组与安慰剂治疗组之间，以及ω-3治疗组与安慰剂治疗组之间，在握力、步行速度、简短身体功能测试（步行速度、平衡和起坐的综合指标）和TUG的变化方面无差异。总体效果在性别、年龄、体重指数，或总25-羟基维生素D（25[OH]D）或游离25[OH]D的基线测量值或血浆ω-3指数方面无差异；在基线总25(OH)D水平高于中位数的参与者中，与安慰剂相比，补充维生素D使TUG略有恶化（P = 0.01；交互作用P = 0.04）。
在这个总体健康的成年人群中，补充维生素D3或海洋ω-3脂肪酸2年均未改善身体功能。
