每日补充维生素D2和维生素D3对血清25-羟基维生素D浓度（总25-（OH）D、25-（羟基）D2和25-（OHD3））的影响以及体重指数重要性的比较：一项系统综述和荟萃分析。

IF 8 1区医学 Q1 NUTRITION & DIETETICS Advances in Nutrition Pub Date : 2024-01-01 DOI:10.1016/j.advnut.2023.09.016

Ellen GHM. van den Heuvel , Paul Lips , Linda J. Schoonmade , Susan A. Lanham-New , Natasja M. van Schoor

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引用次数: 0

摘要

背景：先前的两项荟萃分析显示，维生素D3（D3）和维生素D2（D2）在提高血清25-羟基维生素D[25（OH）D]方面的差异较小，且仅包括每日给药研究时，其异质性始终较高。目的：比较更频繁给药的D2和D3在改善总25（OH）D方面的作用，并确定反应调节剂对异质性的伴随影响，其次比较25（OH（OH）D2中D2相关的变化和25（OH，OH）D3中D3相关的变化（PROSPERO 2021 CRD42021272674）。方法：PubMed，EMBASE，检索Cochrane和Web of Science Core收集的D2与D3的随机对照试验，每天或每周给药一次/两次。在筛选合格性后，提取相关数据进行荟萃分析，以确定当使用不同的25（OH）D分析方法时的标准化平均差（SMD）。否则，确定加权平均差（WMD）。结果：总的来说，基于20项比较研究的结果表明，D3在提高总25（OH）D浓度方面优于D2，但D2和D3对其相应的25（OH-）D羟基化形式具有相似的积极影响。使用LCMS/MS分析的基于12个全日给药D2-D3比较的总25（OH）D的WMD变化，D2组比D3组低10.39 nmol/l（40%）（95%CI-14.62，-6.16；I2=64%；p25kg/m2（p=0.99）。然而，BMI信息仅在13/17日给药比较中可用。结论：即使仅限于每日剂量研究，D3也会导致25（OH）D比D2更大的增加，但D2和D3对其相应的25（OH-）D羟基化形式具有相似的积极影响。在比较每日补充维生素D2和维生素D3对总25（OH）D浓度的影响时，应考虑BMI。意义陈述：先前的荟萃分析表明，维生素D3在增加血清25（OH）D浓度方面可能比维生素D2更有效。此外，与其他剂量（如每月/每次）相比，每天给药的差异似乎较小。我们的荟萃分析在比较通常推荐的更频繁的给药方案时证实了这一点，即每天和每周，尽管残余异质性仍然很高。BMI和基线25（OH）D浓度可能有助于这种残余变异性，因此在建议每天使用维生素D2或D3进行干预时可以考虑。

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Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH)D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis

Background

Two previous meta-analyses showed smaller differences between vitamin D3 and vitamin D2 in raising serum 25-hydroxyvitamin D [25(OH)D] and a consistently high heterogeneity when only including daily dosing studies.

Objective

This study aimed to compare more frequently dosed vitamin D2 and vitamin D3 in improving total 25(OH)D and determine the concomitant effect of response modifiers on heterogeneity, and secondly, to compare the vitamin D2-associated change in 25(OH)D2 with the vitamin D3-associated change in 25(OH)D3.

Methods

PubMed, EMBASE, Cochrane, and the Web of Science Core collection were searched for randomized controlled trials of vitamin D2 compared with vitamin D3, daily or once/twice weekly dosed. After screening for eligibility, relevant data were extracted for meta-analyses to determine the standardized mean difference when different methods of 25(OH)D analyses were used. Otherwise, the weighted mean difference (WMD) was determined.

Results

Overall, the results based on 20 comparative studies showed vitamin D3 to be superior to vitamin D2 in raising total 25(OH)D concentrations, but vitamin D2 and vitamin D3 had a similar positive impact on their corresponding 25(OH)D hydroxylated forms. The WMD in change in total 25(OH)D based on 12 daily dosed vitamin D2-vitamin D3 comparisons, analyzed using liquid chromatography-tandem mass spectrometry, was 10.39 nmol/L (40%) lower for the vitamin D2 group compared with the vitamin D3 group (95% confidence interval: −14.62, −6.16; I² = 64%; P < 00001). Body mass index (BMI) appeared to be the strongest response modifier, reducing heterogeneity to 0% in both subgroups. The vitamin D2- and vitamin D3-induced change in total 25(OH)D lost significance predominantly in subjects with a BMI >25 kg/m² (P = 0.99). However, information on BMI was only available in 13/17 daily dosed comparisons.

Conclusions

Vitamin D3 leads to a greater increase of 25(OH)D than vitamin D2, even if limited to daily dose studies, but vitamin D2 and vitamin D3 had similar positive impacts on their corresponding 25(OH)D hydroxylated forms. Next to baseline 25(OH)D concentration, BMI should be considered when comparing the effect of daily vitamin D2 and vitamin D3 supplementation on total 25(OH)D concentration.

This study was registered in PROSPERO as CRD42021272674.

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.