Lancet子刊:50万人数据揭示日常补充维生素D对急性呼吸道感染的预防作用

2021-04-03 Nebula MedSci原创

日常补充维生素D可预防急性呼吸道感染吗?

2017年,一项对25个关于补充维生素D(VitD)预防急性呼吸道感染(ARI)的随机对照试验(RCT)的荟萃分析显示,该干预具有保护作用。本研究旨在在最新的荟萃分析中检查补充VitD与预防ARI的相关性

研究人员检索了MEDLINE、Embase、对照试验的Cochrane中央注册系统、Web of Science和ClinicalTrials.gov注册中心数据库2020年5月1日前的双盲研究,纳入对比补充VitD3、VitD2或25[OH]D对比安慰剂或低剂量VitD对照试验。

总体上,共筛查了1528篇文章,其中46项RCT(共75541位受试者)复合要求。在43项研究49419位受试者中有48488位(98.1%)的主要预后数据可及。

各试验中罹患一种或多种ARI的患者比例

在补充VitD组,患有一种或多种ARI的患者比例明显低于安慰剂组(61.3%[14332/23364] vs 62.3%[14217/22802];优势比[OR] 0.92,p=0.018)。无论补充多少浓度的25(OH)D对罹患一种或多种ARI的风险均无显著影响。

但是,在每日予以补充VitD的试验中,展示出了对ARI的预防作用(OR 0.78,19项研究,p=0.03):日补充剂量 400-1000IU(0.70, p=0.16)、持续补充不超过12个月(0.82,p=0.021)、入组年龄在1-16岁(0.71,p=0.90)。

随机安慰剂为对照的试验的次要预后

补充VitD组与安慰剂组和剂量、频率、研究持续时间或年龄之间无显著相互作用。此外,补充VitD组与安慰剂组的不良事件发生情况也无明显差别。

总而言之,虽然各试验之间存在明显的异质性,但仍能证明与安慰剂相比,补充VitD是安全的,且可降低ARI的总体风险,虽然降低幅度不大

原始出处:

David A Jolliffe, et al. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. The Lancet Diabetes &Endocrinology. March 30, 2021

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    2021-09-20 howi
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    2021-04-05 zhmscau
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    2021-04-03 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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