Abstract

Previous randomised controlled trials have shown the controversial effectiveness of oral vitamin D supplementation in preventing osteoporotic fractures. PubMed, EMBASE and Cochrane Library electronic databases were searched. Pairwise meta-analysis, Bayesian network meta-analysis and meta-regression were applied. A total of 33 studies containing 83,083 participants were included. Oral vitamin D supplementation showed no statistically significant on reducing the risk of total fractures (RR = 0.96, 95%CI = 0.87–1.05 p = 0.389). Vitamin D₃ (700–800IU/d) plus calcium showed statistical significance in reducing the incidence of total, hip and non-vertebral fractures in the pairwise meta-analysis. Significant reductions were specifically identified in female in total and hip fractures. However, we did not observe any above significant results using Bayesian network meta-analyses. Strikingly, a meta-regression analysis identified an inverse association between the efficacy of fracture prevention and increased body mass index. Thus, we recommended that the vitamin D dose should be adjusted according to BMI based on further confirmation.

摘要

以前的随机对照试验表明口服维生素 D 补充剂在预防骨质疏松性骨折方面的有效性存在争议。检索了 PubMed、EMBASE 和 Cochrane 图书馆电子数据库。应用成对荟萃分析、贝叶斯网络荟萃分析和荟萃回归。共纳入 33 项研究，包含 83,083 名参与者。口服维生素 D 补充剂在降低总骨折风险方面没有统计学意义（RR = 0.96，95%CI = 0.87–1.05 p  = 0.389）。维生素 D ₃(700–800IU/d) 加钙在成对荟萃分析中显示出降低总骨折、髋部和非椎骨骨折发生率的统计学显着性。女性的整体骨折和髋部骨折明显减少。然而，我们没有使用贝叶斯网络荟萃分析观察到任何上述显着结果。引人注目的是，一项元回归分析发现预防骨折的功效与增加的体重指数之间存在负相关。因此，我们建议在进一步确认的基础上，根据 BMI 调整维生素 D 剂量。