Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials
Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, Salovaara K, Cooper C, Smith HE, Jacobs ET, Torgerson D, Jackson RD, Manson JE, Brixen K, Mosekilde L, Robbins JA, Francis RM, Abrahamsen B
The Journal of clinical endocrinology and metabolism · 141 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute for Health and Care Research
- Gobierno
- National Institutes of Health
- Gobierno
- National Cancer Institute
- Gobierno
- NCI NIH HHS
- Gobierno
- Medical Research Council
- Gobierno
- Chief Scientist Office
- Gobierno
- National Institute for Health Research (NIHR)
- Gobierno
- WHI NIH HHS
- Subvenciones
- National Cancer Institute (U01CA138962); National Institute for Health and Care Research (NF-SI-0508-10082); National Institutes of Health (N01 WH022110)
Según 8 financiadores declarados.
Publicación
- Publicado
- 2012-05-17 · J Clin Endocrinol Metab · vol. 97 · número 8 · págs. 2670–2681
- Editorial
- Oxford University Press
- Citado
- 201 citas · más que el 100% de estudios similares · 22.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 60 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Bone health and osteoporosis research · Nutrition and Health Studies
- Palabras clave
- vitamin D, calcium supplementation, mortality, older adults, number needed to treat, randomized controlled trials
- MeSH
- humans, calcium, vitamin d, mortality, proportional hazards models, aged, middle aged, female, male, randomized controlled trials as topic
18 autores
- Lars Rejnmark🇩🇰 · autor de correspondenciaAarhus University Hospital
- Alison Avenell🇬🇧University of Aberdeen
- Tahir Masud🇬🇧🇩🇰Nottingham University Hospitals NHS Trust; University of Southern Denmark
- Frazer H. Anderson🇬🇧University of Southampton
- Helmut E. Meyer🇳🇴Norwegian Institute of Public Health; University of Oslo
- Kerrie M. Sanders🇦🇺The University of Melbourne; Western Health; Western Hospital
- Kari Salovaara🇫🇮University of Eastern Finland; Kuopio University Hospital
- Cyrus C. Cooper🇬🇧University of Oxford; MRC Lifecourse Epidemiology Unit; University of Southampton; Medical Research Council
- Helen Elizabeth Smith🇬🇧Brighton and Sussex Medical School
- Elizabeth T. Jacobs🇺🇸University of Arizona; University of Arizona Cancer Center
- David John Torgerson🇬🇧University of York
- Rebecca D. Jackson🇺🇸The Ohio State University
- JoAnn E. Manson🇺🇸Brigham and Women's Hospital; Harvard University
- Kim Brixen🇩🇰University of Southern Denmark; Odense University Hospital
- Leif Mosekilde🇩🇰Aarhus University Hospital
- John A. Robbins🇺🇸University of California Davis Medical Center; University of California, Davis
- Roger M. Francis🇬🇧Newcastle University
- Bo Abrahamsen🇩🇰University of Southern Denmark; Gentofte Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Introduction
Vitamin D may affect multiple health outcomes. If so, an effect on mortality is to be expected. Using pooled data from randomized controlled trials, we performed individual patient data (IPD) and trial level meta-analyses to assess mortality among participants randomized to either vitamin D alone or vitamin D with calcium.
Subjects and methods
Through a systematic literature search, we identified 24 randomized controlled trials reporting data on mortality in which vitamin D was given either alone or with calcium. From a total of 13 trials with more than 1000 participants each, eight trials were included in our IPD analysis. Using a stratified Cox regression model, we calculated risk of death during 3 yr of treatment in an intention-to-treat analysis. Also, we performed a trial level meta-analysis including data from all studies.
Results
The IPD analysis yielded data on 70,528 randomized participants (86.8% females) with a median age of 70 (interquartile range, 62-77) yr. Vitamin D with or without calcium reduced mortality by 7% [hazard ratio, 0.93; 95% confidence interval (CI), 0.88-0.99]. However, vitamin D alone did not affect mortality, but risk of death was reduced if vitamin D was given with calcium (hazard ratio, 0.91; 95% CI, 0.84-0.98). The number needed to treat with vitamin D plus calcium for 3 yr to prevent one death was 151. Trial level meta-analysis (24 trials with 88,097 participants) showed similar results, i.e. mortality was reduced with vitamin D plus calcium (odds ratio, 0.94; 95% CI, 0.88-0.99), but not with vitamin D alone (odds ratio, 0.98; 95% CI, 0.91-1.06).
Conclusion
Vitamin D with calcium reduces mortality in the elderly, whereas available data do not support an effect of vitamin D alone.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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