JCEM：维生素D与钙减少老年人死亡率

近日，一项研究证实维生素D和钙同时使用可降低死亡率，但单用维生素D却不会带来此种功效。

这项刊登在在Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM)杂志上的一项研究表明：当摄入维生素D时，同时服用钙可以降低老年人死亡率，因此该项研究提出了一个可能延长寿命的手段。

在过去十年中，已经有越来越多研究证实维生素D有潜在的健康益处，如钙与维生素D补充剂会降低骨折的风险。本研究评估维生素D与钙联合使用或维生素D单用的患者的死亡率。研究结果发现，死亡率的降低不是由于骨折数量发生较少带来的。

Lars Rejnmark博士表示：我们的研究结果表明使用补充维生素D与钙相结合的老年患者死亡率降低，但这些结果并没有证实仅使用维生素D的患者死亡率也下降。

doi:10.1210/jc.2011-3328
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Vitamin D with Calcium Reduces Mortality: Patient Level Pooled Analysis of 70,528 Patients from Eight Major Vitamin D Trials.

Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, Salovaara K, Cooper C, Smith HE, Jacobs ET, Torgerson D, Jackson RD, Manson JE, Brixen K, Mosekilde L, Robbins JA, Francis RM, Abrahamsen B.

Abstract

Introduction:Vitamin D may affect multiple health outcomes. If so, an effect on mortality is to be expected. Using pooled data from randomized controlled trials, we performed individual patient data (IPD) and trial level meta-analyses to assess mortality among participants randomized to either vitamin D alone or vitamin D with calcium.Subjects and Methods:Through a systematic literature search, we identified 24 randomized controlled trials reporting data on mortality in which vitamin D was given either alone or with calcium. From a total of 13 trials with more than 1000 participants each, eight trials were included in our IPD analysis. Using a stratified Cox regression model, we calculated risk of death during 3 yr of treatment in an intention-to-treat analysis. Also, we performed a trial level meta-analysis including data from all studies.Results:The IPD analysis yielded data on 70,528 randomized participants (86.8% females) with a median age of 70 (interquartile range, 62-77) yr. Vitamin D with or without calcium reduced mortality by 7% [hazard ratio, 0.93; 95% confidence interval (CI), 0.88-0.99]. However, vitamin D alone did not affect mortality, but risk of death was reduced if vitamin D was given with calcium (hazard ratio, 0.91; 95% CI, 0.84-0.98). The number needed to treat with vitamin D plus calcium for 3 yr to prevent one death was 151. Trial level meta-analysis (24 trials with 88,097 participants) showed similar results, i.e. mortality was reduced with vitamin D plus calcium (odds ratio, 0.94; 95% CI, 0.88-0.99), but not with vitamin D alone (odds ratio, 0.98; 95% CI, 0.91-1.06).Conclusion:Vitamin D with calcium reduces mortality in the elderly, whereas available data do not support an effect of vitamin D alone.