维生素D对增龄性肌肉衰减症影响的系统综述  

Systematic review of the efficacy of vitamin D supplementation on age-related sarcopenia

作　　者：孟丽苹 李洪亮[1] 杨畅 续晓敏 刘思远 何梅 于康[3] Meng Liping;Li Hongliang;Yang Chang;Xu Xiaomin;Liu Siyuan;He Mei;Yu Kang(Inner Mongolia Mengniu Dairy(Group)Co.,Ltd.,Hohhot 011500,China;Geriatric Nutrition Branch of Chinese Nutrition Society,Beijing 100053,China;Department of Clinical Nutrition,Department of Health Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]内蒙古蒙牛乳业(集团)股份有限公司,呼和浩特011500 [2]中国营养学会老年营养分会,北京100053 [3]中国医学科学院北京协和医学院北京协和医院临床营养科,北京100730

出　　处：《中华健康管理学杂志》2024年第11期861-868,共8页Chinese Journal of Health Management

摘　　要：目的系统综述维生素D对增龄性肌肉衰减症的影响。方法本研究为系统综述, 在PubMed、Web of Science、中国知网、万方等数据检索平台, 对2014年1月31日至2024年1月31日收录的期刊、学位论文等科学研究进行综合性文献检索, 采用检索词和引文两种方式检索, 以确保获得文献的全面性。以"维生素D""肌肉""骨骼肌""肌肉衰减""少肌症""握力""步速""vitamin D""ergocalciferols""cholecalciferol""sarcopenia""muscle mass""muscle strength""myopenia""muscle loss""muscle reduction""gait speed""grip strength""handgrip"等为检索词, 重点检索、评估随机对照试验(RCT)及基于RCT的系统综述/荟萃分析, 总结单一维生素D干预对增龄性肌肉衰减症影响的科学证据, 排除特定疾病状态、儿童青少年、绝经期女性、运动员等特定人群的研究。结果共检索到中英文文献2 448篇, 符合纳入和排除标准的系统综述/荟萃分析8篇、RCT研究22篇。尽管早期的一些较低质量研究报道了维生素D补充对骨骼肌力量的小幅度提升, 但近3年的高质量系统综述/荟萃分析并未发现维生素D干预对肌肉衰减症及其分解指标(骨骼肌质量、力量和功能)有显著的积极影响。干预效果在一定程度上受研究对象基线肌肉健康的水平、维生素D营养状况的影响。结论目前尚无足够证据表明单纯维生素D补充对增龄性肌肉衰减症起到显著改善作用, 需要更多的高质量临床研究以不断积累科学证据。Objective To consolidate the current evidences regarding the efficacy of vitamin D supplementation in age-related sarcopenia.Methods In this systemic review,a comprehensive literature search of scientific research including journal articles and academic dissertations was performed in prominent databases such as PubMed,Web of Science,China National Knowledge Infrastructure(CNKI)and Wanfang Database platforms,spanning from January adopted to ensure comprehensiveness of the literature.Using"vitamin D""ergocalciferols""cholecalciferol""sarcopenia""muscle mass""muscle strength""myopenia""muscle loss""muscle reduction""gait speed""grip strength""handgrip"as the main key words,focusing on the systematic reviews,meta-analyses of randomized controlled trials(RCT),and individual RCT,the scientific evidence of individual vitamin D intervention on age-related sarcopenia was evaluated and summarized.Research concerning particular disease conditions,children and adolescents,menopausal women,athletes and other specific populations were excluded.Results A initial search yielded 2448 articles in Chinese or English.A total of 8 systemic reviews/meta-analysis and 22 individual RCT literatures were included in the final analysis.Although some earlier lower-quality studies reported subtle improvements in skeletal muscle strength with vitamin D supplementation,high-quality systematic reviews/meta-analysis over the past three years had not shown significant positive effects of vitamin D intervention on sarcopenia and its breakdown parameters,such as skeletal muscle mass,muscle strength,and muscle function.Furthermore,the efficiency was influenced to some extent by the participants'baseline status,such as muscle health and vitamin D nutritional status.Conclusions Present evidence does not robustly support the efficacy of sole vitamin D supplement on age-related sarcopenia.High-quality clinical trials are imperative to accumulate more robust evidence in the future.

关 键 词：维生素D 肌肉衰减症 年龄因素 肌肉骨骼发育 肌肉质量 肌肉功能 

分 类 号：R685[医药卫生—骨科学]