Singh Shruti, Meena Rajesh Kumar, Maharshi Vikas, Sinha Nishi, Agarwal Neha, Payra Shuvasree, Harsha Divya
Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India.
Perspect Clin Res. 2025 Apr-Jun;16(2):69-74. doi: 10.4103/picr.picr_325_23. Epub 2025 Jan 31.
Vitamin D supplementation studies in various pleiotropic outcomes often yield conflicting results. This complexity arises from various factors, including individual differences (baseline Vitamin D levels, genetics, ethnicity, age, and gender). This review aims to clarify the complexities in Vitamin D supplementation research by examining various influencing factors, ultimately providing a comprehensive understanding to guide future studies and offer more accurate insights into the health impacts of Vitamin D supplementation. For this review, we searched PubMed, Google Scholar, and ScienceDirect, analyzing observational studies, meta-analyses, and randomized controlled trials to identify key factors influencing the efficacy of Vitamin D supplementation. By synthesizing findings from diverse research, we aimed to illuminate the nuances shaping the outcomes of these trials. In conclusion, the review suggests that several demographic and biological factors such as baseline 25(OH)D levels, age, ethnicity, genetics, body mass index, diet, sun exposure, medications, comorbid conditions, socioeconomic status, and self-supplementation all play significant roles in the outcomes of Vitamin D supplementation trials. In addition, the dose and duration of therapy, choice of daily versus bolus dosing, route of administration, and the role of free and bound forms of Vitamin D contribute to the complexity of trial results. Vitamin D's pleiotropic effects extend beyond calcium regulation, impacting various health aspects. Inadequate blood levels can confound trial outcomes, emphasizing the importance of reaching appropriate 25(OH)D thresholds. Study design, sample size, bias minimization, and methodology are critical in influencing trial outcomes and designing studies that account for baseline levels and compliance is crucial for meaningful and accurate results. Standardized assays and internationally agreed-upon cutoff levels are essential to mitigate variability in 25(OH)D measurements and improve result reliability.
在各种多效性结局中进行维生素D补充研究时，常常会得出相互矛盾的结果。这种复杂性源于多种因素，包括个体差异（基线维生素D水平、基因、种族、年龄和性别）。本综述旨在通过研究各种影响因素来阐明维生素D补充研究中的复杂性，最终提供全面的理解，以指导未来的研究，并对维生素D补充对健康的影响提供更准确的见解。在本综述中，我们检索了PubMed、谷歌学术和科学Direct，分析观察性研究、荟萃分析和随机对照试验，以确定影响维生素D补充疗效的关键因素。通过综合不同研究的结果，我们旨在阐明影响这些试验结果的细微差别。总之，该综述表明，一些人口统计学和生物学因素，如基线25(OH)D水平、年龄、种族、基因、体重指数、饮食、阳光照射、药物、合并症、社会经济地位和自我补充，在维生素D补充试验的结果中都起着重要作用。此外，治疗的剂量和持续时间、每日给药与大剂量给药的选择、给药途径以及维生素D游离形式和结合形式的作用，都导致了试验结果的复杂性。维生素D的多效性作用不仅限于钙调节，还会影响多个健康方面。血液水平不足会混淆试验结果，这凸显了达到适当的25(OH)D阈值的重要性。研究设计、样本量、偏差最小化和方法学在影响试验结果方面至关重要，设计考虑基线水平和依从性的研究对于获得有意义和准确的结果至关重要。标准化检测方法和国际商定的临界值对于减少25(OH)D测量的变异性和提高结果可靠性至关重要。
