Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis
Reid IR, Bolland MJ, Grey A
Lancet (London, England) · 449 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Health Research Council of New Zealand
Según 1 financiador declarado.
Publicación
- Publicado
- 2013-10-10 · Lancet · vol. 383 · número 9912 · págs. 146–155
- Editorial
- Elsevier BV
- Citado
- 677 citas · más que el 100% de estudios similares · 9.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 68 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Bone health and osteoporosis research · Vitamin K Research Studies
- Palabras clave
- vitamin D supplementation, bone mineral density, vitamin D deficiency, femoral neck, hip bone density, older women, fracture prevention, vitamin D dose, 25-hydroxyvitamin D, calcium supplementation, osteoporosis prevention, lumbar spine, total hip, trochanter, forearm bone mineral density, publication bias, selective reporting
- MeSH
- humans, osteoporosis, cholecalciferol, ergocalciferols, vitamin d, bone density, dietary supplements, aged, female, male
3 autores
- Ian R. Reid🇳🇿 · autor de correspondenciaUniversity of Auckland; Auckland District Health Board
- Mark J Bolland🇳🇿University of Auckland
- Andrew B. Grey🇳🇿University of Auckland; Auckland District Health Board
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Findings from recent meta-analyses of vitamin D supplementation without co-administration of calcium have not shown fracture prevention, possibly because of insufficient power or inappropriate doses, or because the intervention was not targeted to deficient populations. Despite these data, almost half of older adults (older than 50 years) continue to use these supplements. Bone mineral density can be used to detect biologically significant effects in much smaller cohorts. We investigated whether vitamin D supplementation affects bone mineral density.
Methods
We searched Web of Science, Embase, and the Cochrane Database, from inception to July 8, 2012, for trials assessing the effects of vitamin D (D3 or D2, but not vitamin D metabolites) on bone mineral density. We included all randomised trials comparing interventions that differed only in vitamin D content, and which included adults (average age >20 years) without other metabolic bone diseases. We pooled data with a random effects meta-analysis with weighted mean differences and 95% CIs reported. To assess heterogeneity in results of individual studies, we used Cochran's Q statistic and the I(2) statistic. The primary endpoint was the percentage change in bone mineral density from baseline.
Findings
Of 3930 citations identified by the search strategy, 23 studies (mean duration 23·5 months, comprising 4082 participants, 92% women, average age 59 years) met the inclusion criteria. 19 studies had mainly white populations. Mean baseline serum 25-hydroxyvitamin D concentration was less than 50 nmol/L in eight studies (n=1791). In ten studies (n=2294), individuals were given vitamin D doses less than 800 IU per day. Bone mineral density was measured at one to five sites (lumbar spine, femoral neck, total hip, trochanter, total body, or forearm) in each study, so 70 tests of statistical significance were done across the studies. There were six findings of significant benefit, two of significant detriment, and the rest were non-significant. Only one study showed benefit at more than one site. Results of our meta-analysis showed a small benefit at the femoral neck (weighted mean difference 0·8%, 95% CI 0·2-1·4) with heterogeneity among trials (I(2)=67%, p<0·00027). No effect at any other site was reported, including the total hip. We recorded a bias toward positive results at the femoral neck and total hip.
Interpretation
Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate.
Funding
Health Research Council of New Zealand.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
Confianza de la comunidad
Cargando…
¿Cuánto confías en los hallazgos de este estudio?
Comentarios
¿Algo está mal aquí?
Señala este estudio si su información, etiquetas o financiación parecen incorrectas. Un editor revisa cada señalamiento.
Información educativa sobre investigación publicada. No es consejo médico ni una recomendación para empezar o dejar nada.