Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults

医学 维生素D与神经学 随机对照试验 入射(几何) 骨质疏松症 荟萃分析 内科学 安慰剂 相对风险 科克伦图书馆 物理疗法 置信区间 替代医学 病理 物理 光学
作者
Jia‐Guo Zhao,Xiantie Zeng,Jia Wang,Lin Liu
出处
期刊:JAMA [American Medical Association]
卷期号:318 (24): 2466-2466 被引量:474
标识
DOI:10.1001/jama.2017.19344
摘要

Importance

The increased social and economic burdens for osteoporosis-related fractures worldwide make the prevention of such injuries a major public health goal. Previous studies have reached mixed conclusions regarding the association between calcium, vitamin D, or combined calcium and vitamin D supplements and fracture incidence in older adults.

Objective

To investigate whether calcium, vitamin D, or combined calcium and vitamin D supplements are associated with a lower fracture incidence in community-dwelling older adults.

Data Sources

The PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to December 24, 2016, using the keywordscalcium,vitamin D, andfractureto identify systematic reviews or meta-analyses. The primary randomized clinical trials included in systematic reviews or meta-analyses were identified, and an additional search for recently published randomized trials was performed from July 16, 2012, to July 16, 2017.

Study Selection

Randomized clinical trials comparing calcium, vitamin D, or combined calcium and vitamin D supplements with a placebo or no treatment for fracture incidence in community-dwelling adults older than 50 years.

Data Extraction and Synthesis

Two independent reviewers performed the data extraction and assessed study quality. A meta-analysis was performed to calculate risk ratios (RRs), absolute risk differences (ARDs), and 95% CIs using random-effects models.

Main Outcomes and Measures

Hip fracture was defined as the primary outcome. Secondary outcomes were nonvertebral fracture, vertebral fracture, and total fracture.

Results

A total of 33 randomized trials involving 51 145 participants fulfilled the inclusion criteria. There was no significant association of calcium or vitamin D with risk of hip fracture compared with placebo or no treatment (calcium: RR, 1.53 [95% CI, 0.97 to 2.42]; ARD, 0.01 [95% CI, 0.00 to 0.01]; vitamin D: RR, 1.21 [95% CI, 0.99 to 1.47]; ARD, 0.00 [95% CI, −0.00 to 0.01]. There was no significant association of combined calcium and vitamin D with hip fracture compared with placebo or no treatment (RR, 1.09 [95% CI, 0.85 to 1.39]; ARD, 0.00 [95% CI, −0.00 to 0.00]). No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of nonvertebral, vertebral, or total fractures. Subgroup analyses showed that these results were generally consistent regardless of the calcium or vitamin D dose, sex, fracture history, dietary calcium intake, and baseline serum 25-hydroxyvitamin D concentration.

Conclusions and Relevance

In this meta-analysis of randomized clinical trials, the use of supplements that included calcium, vitamin D, or both compared with placebo or no treatment was not associated with a lower risk of fractures among community-dwelling older adults. These findings do not support the routine use of these supplements in community-dwelling older people.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
赘婿应助kk_yang采纳,获得10
1秒前
成就伟祺关注了科研通微信公众号
2秒前
能干的语芙完成签到 ,获得积分10
2秒前
无欲无求傻傻完成签到,获得积分10
2秒前
2秒前
2秒前
尊敬寒松完成签到 ,获得积分10
2秒前
糊涂的麦片完成签到,获得积分10
2秒前
3秒前
3秒前
4秒前
wanci应助wangdafa采纳,获得10
4秒前
竹子co完成签到,获得积分10
4秒前
steventj完成签到,获得积分10
4秒前
yz完成签到 ,获得积分10
5秒前
朴实山兰完成签到,获得积分10
6秒前
tkkdy发布了新的文献求助10
6秒前
蓁蓁发布了新的文献求助10
6秒前
醉熏的鑫发布了新的文献求助10
7秒前
独家双层汉堡完成签到,获得积分10
7秒前
Li完成签到,获得积分10
8秒前
xcx发布了新的文献求助10
8秒前
江小小发布了新的文献求助10
9秒前
9秒前
乐乐乐乐乐乐应助大橙子采纳,获得10
9秒前
伍六七完成签到,获得积分10
10秒前
shinen发布了新的文献求助10
10秒前
文艺的又亦完成签到,获得积分10
10秒前
小蘑菇应助妍儿采纳,获得10
11秒前
12秒前
义气天真完成签到,获得积分10
12秒前
满意易蓉发布了新的文献求助10
13秒前
13秒前
303完成签到 ,获得积分10
14秒前
海阔光明完成签到,获得积分10
14秒前
酷波er应助樾苒采纳,获得10
14秒前
Bingo完成签到,获得积分10
15秒前
hhhh完成签到 ,获得积分10
15秒前
小Q完成签到,获得积分10
16秒前
wangdafa发布了新的文献求助10
16秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds第二卷 1200
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038657
求助须知:如何正确求助?哪些是违规求助? 3576306
关于积分的说明 11375198
捐赠科研通 3306108
什么是DOI,文献DOI怎么找? 1819379
邀请新用户注册赠送积分活动 892698
科研通“疑难数据库(出版商)”最低求助积分说明 815066