{"title":"用补充钙和维生素 D 对骨质疏松老年人进行营养治疗:副作用、骨折率和存活率 - 一项国际化的荟萃分析。","authors":"Du Jiao, Chao Jiang","doi":"10.6133/apjcn.202403_33(1).0001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent controversy over the bone benefits of calcium and vitamin D supplementation, and the potential detrimental effects of excess calcium supplementation, has confused clinicians. To systematically evaluate the effectiveness and safety of vitamin D combined with calcium in preventing and treating osteoporotic symptoms in the elderly.</p><p><strong>Methods and study design: </strong>Databases were searched to collect randomized controlled trials (RCTs) on vitamin D combined with calcium in the prevention and treatment of osteoporotic fractures in the elderly. After screening the literature, extracting data, and assessing the risk of bias in the included studies, the Meta-analysis was performed.</p><p><strong>Results: </strong>19 RCTs were included, including 69,234 patients. Meta-analysis results showed that the mortality rate of the vitamin D combined with calcium group was not statistically significant compared with the control group; the calcium combined with vitamin D significantly reduced the incidence of fractures compared with the control group,Density and serum 25-hydroxyl concentration, adverse reactions of calcium combined with vitamin D were higher than those in the control group.</p><p><strong>Conclusions: </strong>The combination of vitamin D and calcium has no difference in mortality rate, and it can prevent fractures in the elderly, and enhance bone density and serum 25-hydroxyvitamin D concentration, but still need to pay attention to adverse reactions in the gastrointestinal tract.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 1","pages":"1-10"},"PeriodicalIF":1.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170020/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nutritional therapy of older osteoporotic people with supplemental calcium and vitamin D: side effects, fracture rates, and survival - an internationalised meta-analysis.\",\"authors\":\"Du Jiao, Chao Jiang\",\"doi\":\"10.6133/apjcn.202403_33(1).0001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Recent controversy over the bone benefits of calcium and vitamin D supplementation, and the potential detrimental effects of excess calcium supplementation, has confused clinicians. To systematically evaluate the effectiveness and safety of vitamin D combined with calcium in preventing and treating osteoporotic symptoms in the elderly.</p><p><strong>Methods and study design: </strong>Databases were searched to collect randomized controlled trials (RCTs) on vitamin D combined with calcium in the prevention and treatment of osteoporotic fractures in the elderly. After screening the literature, extracting data, and assessing the risk of bias in the included studies, the Meta-analysis was performed.</p><p><strong>Results: </strong>19 RCTs were included, including 69,234 patients. Meta-analysis results showed that the mortality rate of the vitamin D combined with calcium group was not statistically significant compared with the control group; the calcium combined with vitamin D significantly reduced the incidence of fractures compared with the control group,Density and serum 25-hydroxyl concentration, adverse reactions of calcium combined with vitamin D were higher than those in the control group.</p><p><strong>Conclusions: </strong>The combination of vitamin D and calcium has no difference in mortality rate, and it can prevent fractures in the elderly, and enhance bone density and serum 25-hydroxyvitamin D concentration, but still need to pay attention to adverse reactions in the gastrointestinal tract.</p>\",\"PeriodicalId\":8486,\"journal\":{\"name\":\"Asia Pacific journal of clinical nutrition\",\"volume\":\"33 1\",\"pages\":\"1-10\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170020/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia Pacific journal of clinical nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.6133/apjcn.202403_33(1).0001\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Pacific journal of clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.6133/apjcn.202403_33(1).0001","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的:最近关于补充钙和维生素 D 对骨骼的益处以及过量补充钙可能产生的有害影响的争议让临床医生感到困惑。目的:系统评估维生素 D 与钙结合预防和治疗老年人骨质疏松症状的有效性和安全性:检索数据库,收集有关维生素 D 联合钙剂预防和治疗老年人骨质疏松性骨折的随机对照试验(RCT)。在筛选文献、提取数据并评估纳入研究的偏倚风险后,进行了 Meta 分析:结果:共纳入 19 项研究,包括 69 234 名患者。Meta分析结果显示,与对照组相比,维生素D联合钙剂组的死亡率无统计学意义;与对照组相比,钙剂联合维生素D可显著降低骨折发生率,钙剂联合维生素D组的密度、血清25-羟基浓度、不良反应均高于对照组:维生素D与钙联合应用在死亡率上无差异,且能预防老年人骨折,提高骨密度和血清25-羟维生素D浓度,但仍需注意胃肠道的不良反应。
Nutritional therapy of older osteoporotic people with supplemental calcium and vitamin D: side effects, fracture rates, and survival - an internationalised meta-analysis.
Background and objectives: Recent controversy over the bone benefits of calcium and vitamin D supplementation, and the potential detrimental effects of excess calcium supplementation, has confused clinicians. To systematically evaluate the effectiveness and safety of vitamin D combined with calcium in preventing and treating osteoporotic symptoms in the elderly.
Methods and study design: Databases were searched to collect randomized controlled trials (RCTs) on vitamin D combined with calcium in the prevention and treatment of osteoporotic fractures in the elderly. After screening the literature, extracting data, and assessing the risk of bias in the included studies, the Meta-analysis was performed.
Results: 19 RCTs were included, including 69,234 patients. Meta-analysis results showed that the mortality rate of the vitamin D combined with calcium group was not statistically significant compared with the control group; the calcium combined with vitamin D significantly reduced the incidence of fractures compared with the control group,Density and serum 25-hydroxyl concentration, adverse reactions of calcium combined with vitamin D were higher than those in the control group.
Conclusions: The combination of vitamin D and calcium has no difference in mortality rate, and it can prevent fractures in the elderly, and enhance bone density and serum 25-hydroxyvitamin D concentration, but still need to pay attention to adverse reactions in the gastrointestinal tract.
期刊介绍:
The aims of the Asia Pacific Journal of Clinical Nutrition
(APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of
clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health
promotion and disease prevention. APJCN will publish
original research reports, reviews, short communications
and case reports. News, book reviews and other items will
also be included. The acceptance criteria for all papers are
the quality and originality of the research and its significance to our readership. Except where otherwise stated,
manuscripts are peer-reviewed by at least two anonymous
reviewers and the Editor. The Editorial Board reserves the
right to refuse any material for publication and advises
that authors should retain copies of submitted manuscripts
and correspondence as material cannot be returned. Final
acceptance or rejection rests with the Editorial Board