同位素技术测定钙吸收率的维生素D补充临床试验荟萃分析  

A meta-analysis of clinical trials for vitamin D supplementation on calcium absorption measured with isotopetechniques

作　　者：石昊昱[1] 房爱萍[1] 李可基[1] 

机构地区：[1]北京大学公共卫生学院营养与食品卫生学系,100191

出　　处：《首都公共卫生》2017年第4期145-149,共5页Capital Journal of Public Health

摘　　要：目的汇总分析维生素D补充剂促进钙吸收率作用的临床证据。方法检索Pub Med、Cochrane CENTRAL、Sino Med,收集使用同位素方法测定钙吸收的维生素D补充试验,筛选并提取纳入文献的相关信息,进行随机效应meta分析,结果以加权均数和95%CI表示。结果纳入的9篇文献包括21个处理组,673名受试者,其中470名为老年妇女;补充维生素D 10~1 250μg/d,28~730 d。在受试者血25(OH)D水平均高于20 nmol/L情况下,干预前后钙吸收率没有显著变化(-0.45%[-2.29%,1.39%])。按年龄<18岁,18~55岁,>55岁分组,干预前后也均未见显著差异(-3.59%[-12.8%,5.62%],0.91%[-2.5%,4.32%],-0.23%[-2.39%,1.94%])。根据受试者基线25(OH)D水平、是否同时使用钙剂、膳食钙摄入水平等因素分层,各亚组结果均与合组结果趋势一致。结论在血25(OH)D高于20 nmol/L的受试者中,特别是在老年妇女人群中,没有证据支持补充维生素D促进钙吸收。Objective To summarize clinical evidences on action of vitamin D supplement in promoting calcium absorption. Methods PubMed, Cochrane CENTRAL and Sino Med were searched for trials of vitamin D supplementation on calcium absorption measured by isotope techniques. After study selection and data extraction, recta-analysis with random effects model was performed. The result were reported with weighted mean differences and 95% CIs. Results Nine studies with 21 treatment groups met the inclusion criteria. A total of 673 subjects, including 470 elderly women, were analyzed with daily supplements of 28 - 1 250 p^g vitamin D for 28 - 730 days. There was no significant difference in true fractional calcium absorption from baseline after vitamin D supplementation in the subjects with serum 25 - hydroxyvitamin D levels above 20 nmol/L （ -0.45% [ -2.29%,1.39%]）, and in the subgroups of age of 〈18, 18 -55, and 〉55 years（ -3.59% -12.8%,5.62%], 0.91%[ -2.5%,4.32%],and -0.23% [ -2.39%,1.94%], respectively）. Trends were similar among subjects stratified by baseline 25 - hydroxyvitamin D level, whether in combination with calcium supplements or dietary calcium intakes. Conclusion There was no sufficient evidences of vitamin D supplements in improving calcium absorption among subjects with serum 25 - hydroxyvitamin D levels above 20 nmol/L, especially in elderly women.

关 键 词：维生素D 钙吸收 临床试验 荟萃分析 

分 类 号：R151.2[医药卫生—营养与食品卫生学]