运动和维生素D补充(含钙和不含钙)对老年人骨密度的累加效应:一项系统综述和荟萃分析。

IF 1.1 Q3 ORTHOPEDICS Journal of Osteoporosis Pub Date : 2023-01-01 DOI:10.1155/2023/5570030
Cecilie Fischer, Franz Jakob, Matthias Kohl, Stephanie Kast, Simon Von Stengel, Katharina Kerschan-Schindl, Uwe Lange, Friederike Thomasius, Stefan Peters, Michael Uder, Wolfgang Kemmler
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摘要

运动是预防和治疗骨质疏松症的公认组成部分。本系统综述和荟萃分析旨在确定运动中添加维生素D (vitd)与单独运动对老年人腰椎(LS)或髋关节骨密度(BMD)的影响。根据PRISMA对6个文献数据库进行系统回顾,包括(A)运动试验,运动组(EX)和运动+维生素d联合组(EX +维生素d), (b)干预≥6个月,(c)下肢或髋部骨密度评估。使用随机效应模型(包括逆异质性模型(IVhet))计算效应量(MD)和95%置信区间(95% ci)。5项研究包括281名EX参与者和279名EX + vitd参与者。EX与EX +维生素d在BMD-LS (MD: 0.002, 95%-CI: -0.033 ~ 0.036)或BMD-hip (MD: 0.003, 95%-CI: -0.035 ~ 0.042)方面无显著差异。试验结果之间的异质性在LS (I2 = 0%)和髋-骨密度(I2 = 35%)中为中度。漏斗图分析为BMD-LS和髋关节结果的发表/小研究偏倚提供了证据。总之,本系统综述和荟萃分析无法确定运动和维生素d对LS-或髋关节bmd的显著正相互作用。我们主要将这一发现归因于:(1)五项研究中至少两项的骨骼特异性运动方案较少;(2)研究的纳入标准没有因此关注维生素d缺乏症。这个问题应该通过充分有力的运动试验和有希望的运动方案和维生素d缺乏症的参与者来更详细地解决。该试验已在国际前瞻性系统评价注册(PROSPERO)注册,ID: CRD42022309813。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis.

Exercise is a recognized component in the prevention and therapy of osteoporosis. The present systematic review and meta-analysis aimed to determine the effect of Vitamin D (Vit-D) added to exercise versus exercise alone on bone mineral density (BMD) at the lumbar spine (LS) or hip in older adults. A systematic review based on six literature databases according to PRISMA included (a) exercise trials, with an exercise (EX) and a combined exercise + Vit-D group (EX + Vit-D), (b) intervention ≥ 6 months, and (c) BMD assessments at LS or hip. Effects sizes (MD) and 95%-confidence intervals (95%-CI) were calculated using a random-effect model that includes the inverse heterogeneity model (IVhet). Five studies with 281 participants in the EX and 279 participants in the EX + Vit-D were included. No significant differences between EX versus EX + Vit-D were observed for BMD-LS (MD: 0.002, 95%-CI: -0.033 to 0.036) or BMD-hip (MD: 0.003, 95%-CI: -0.035 to 0.042). Heterogeneity between the trial results was moderate-substantial for LS (I2 = 0%) and moderate for hip-BMD (I2 = 35%). The funnel plot analysis suggests evidence for a publication/small study bias for BMD-LS and hip results. In summary, this present systematic review and meta-analysis were unable to determine significant positive interaction of exercise and Vit-D on LS- or hip-BMD. We predominately attribute this finding to (1) the less bone-specific exercise protocols of at least two of the five studies and (2) the inclusion criteria of the studies that did not consequently focus on Vit-D deficiency. This issue should be addressed in more detail by adequately powered exercise trials with promising exercise protocols and participants with Vit-D deficiency. This trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022309813.

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CiteScore
3.60
自引率
0.00%
发文量
6
审稿时长
20 weeks
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