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老年骨质疏松症患者补充钙和维生素 D 的营养治疗:副作用、骨折率和生存率——一项国际化的荟萃分析。

Nutritional therapy of older osteoporotic people with supplemental calcium and vitamin D: side effects, fracture rates, and survival - an internationalised meta-analysis.

机构信息

Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China.

Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China. Email:

出版信息

Asia Pac J Clin Nutr. 2024 Mar;33(1):1-10. doi: 10.6133/apjcn.202403_33(1).0001.

Abstract

BACKGROUND AND OBJECTIVES

Recent controversy over the bone benefits of calcium and vitamin D supplementation, and the potential detrimental effects of excess calcium supplementation, has confused clinicians. To systematically evaluate the effectiveness and safety of vitamin D combined with calcium in preventing and treating osteoporotic symptoms in the elderly.

METHODS AND STUDY DESIGN

Databases were searched to collect randomized controlled trials (RCTs) on vitamin D combined with calcium in the prevention and treatment of osteoporotic fractures in the elderly. After screening the literature, extracting data, and assessing the risk of bias in the included studies, the Meta-analysis was performed.

RESULTS

19 RCTs were included, including 69,234 patients. Meta-analysis results showed that the mortality rate of the vitamin D combined with calcium group was not statistically significant compared with the control group; the calcium combined with vitamin D significantly reduced the incidence of fractures compared with the control group,Density and serum 25-hydroxyl concentration, adverse reactions of calcium combined with vitamin D were higher than those in the control group.

CONCLUSIONS

The combination of vitamin D and calcium has no difference in mortality rate, and it can prevent fractures in the elderly, and enhance bone density and serum 25-hydroxyvitamin D concentration, but still need to pay attention to adverse reactions in the gastrointestinal tract.

摘要

背景与目的

近年来,关于钙和维生素 D 补充对骨骼益处的争议以及过量钙补充的潜在有害影响使临床医生感到困惑。本研究旨在系统评估维生素 D 联合钙预防和治疗老年骨质疏松症症状的有效性和安全性。

方法和研究设计

检索数据库,收集关于维生素 D 联合钙预防和治疗老年骨质疏松性骨折的随机对照试验(RCT)。筛选文献、提取数据并评估纳入研究的偏倚风险后,进行 Meta 分析。

结果

共纳入 19 项 RCT,包括 69234 名患者。Meta 分析结果显示,维生素 D 联合钙组与对照组的死亡率无统计学差异;与对照组相比,钙联合维生素 D 可显著降低骨折发生率;与对照组相比,钙联合维生素 D 可增加骨密度和血清 25-羟维生素 D 浓度,但不良反应发生率较高。

结论

维生素 D 和钙联合使用在死亡率方面没有差异,可预防老年人骨折,增强骨密度和血清 25-羟维生素 D 浓度,但仍需注意胃肠道不良反应。

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