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Abstract：
BACKGROUND: Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation.
METHODS: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry were searched from database inception through July 13, 2023. Randomized-controlled trials (RCTs) were included. Data were pooled using random-effects model. The primary outcome was the proportion of participants with one or more ARIs.
RESULTS: The analysis included 43 RCTs with 49320 participants. Forty RCTs were considered to be at low risk for bias. The main pairwise meta-analysis indicated there were no significant preventive effects of vitamin D supplementation against ARIs (risk ratio [RR]: 0.99, 95% confidence interval [CI]: 0.97 to 1.01, I2 = 49.6%). The subgroup dose-response meta-analysis indicated that the optimal vitamin D supplementation doses ranged between 400-1200 IU/day for both summer-sparing and winter-dominant subgroups. The subgroup pairwise meta-analysis also revealed significant preventive effects of vitamin D supplementation in subgroups of daily dosing (RR: 0.92, 95% CI: 0.85 to 0.99, I2 = 55.7%, number needed to treat [NNT]: 36), trials duration < 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, I2 = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, I2 = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, I2 = 9.7%, NNT: 10).
CONCLUSIONS: Vitamin D supplementation may slightly prevent ARIs when taken daily at doses between 400 and 1200 IU/d during spring, autumn, or winter, which should be further examined in future clinical trials.
METHODS: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry were searched from database inception through July 13, 2023. Randomized-controlled trials (RCTs) were included. Data were pooled using random-effects model. The primary outcome was the proportion of participants with one or more ARIs.
RESULTS: The analysis included 43 RCTs with 49320 participants. Forty RCTs were considered to be at low risk for bias. The main pairwise meta-analysis indicated there were no significant preventive effects of vitamin D supplementation against ARIs (risk ratio [RR]: 0.99, 95% confidence interval [CI]: 0.97 to 1.01, I2 = 49.6%). The subgroup dose-response meta-analysis indicated that the optimal vitamin D supplementation doses ranged between 400-1200 IU/day for both summer-sparing and winter-dominant subgroups. The subgroup pairwise meta-analysis also revealed significant preventive effects of vitamin D supplementation in subgroups of daily dosing (RR: 0.92, 95% CI: 0.85 to 0.99, I2 = 55.7%, number needed to treat [NNT]: 36), trials duration < 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, I2 = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, I2 = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, I2 = 9.7%, NNT: 10).
CONCLUSIONS: Vitamin D supplementation may slightly prevent ARIs when taken daily at doses between 400 and 1200 IU/d during spring, autumn, or winter, which should be further examined in future clinical trials.
摘要：
背景：补充维生素D可以预防急性呼吸道感染（ARIs）。本研究旨在确定补充维生素D的最佳方法。
方法：PubMed，Embase,Cochrane中央控制试验登记册,WebofScience,和ClinicalTrials.gov注册表从数据库开始到2023年7月13日进行搜索。纳入随机对照试验(RCTs)。使用随机效应模型汇集数据。主要结果是具有一个或多个ARI的参与者的比例。
结果：分析包括43项RCTs和49320名参与者。40项随机对照试验被认为存在低偏倚风险。主要的成对荟萃分析表明，补充维生素D对ARIs没有明显的预防作用（风险比[RR]：0.99，95％置信区间[CI]：0.97至1.01，I2=49.6％）。亚组剂量-反应荟萃分析表明，夏季保留和冬季占优势的亚组的最佳维生素D补充剂量范围为400-1200IU/天。亚组成对荟萃分析还显示，在每日给药的亚组中，补充维生素D具有显着的预防作用（RR：0.92，95％CI：0.85至0.99，I2=55.7％，治疗所需的数量[NNT]：36），试验持续时间<4个月(RR：0.81，95%CI：0.67至0.97，I2=48.8%，NNT：16），夏季保留季节(RR：0.85，95%CI：0.74至0.98，I2=55.8%，NNT：26），和冬季主导季节(RR：0.79，95%CI：0.71至0.89，I2=9.7%，NNT：10）。
结论：在春季每天服用400至1200IU/d的维生素D补充剂可能会稍微预防ARIs，秋天,或者冬天，这应该在未来的临床试验中进一步研究。
方法：PubMed，Embase,Cochrane中央控制试验登记册,WebofScience,和ClinicalTrials.gov注册表从数据库开始到2023年7月13日进行搜索。纳入随机对照试验(RCTs)。使用随机效应模型汇集数据。主要结果是具有一个或多个ARI的参与者的比例。
结果：分析包括43项RCTs和49320名参与者。40项随机对照试验被认为存在低偏倚风险。主要的成对荟萃分析表明，补充维生素D对ARIs没有明显的预防作用（风险比[RR]：0.99，95％置信区间[CI]：0.97至1.01，I2=49.6％）。亚组剂量-反应荟萃分析表明，夏季保留和冬季占优势的亚组的最佳维生素D补充剂量范围为400-1200IU/天。亚组成对荟萃分析还显示，在每日给药的亚组中，补充维生素D具有显着的预防作用（RR：0.92，95％CI：0.85至0.99，I2=55.7％，治疗所需的数量[NNT]：36），试验持续时间<4个月(RR：0.81，95%CI：0.67至0.97，I2=48.8%，NNT：16），夏季保留季节(RR：0.85，95%CI：0.74至0.98，I2=55.8%，NNT：26），和冬季主导季节(RR：0.79，95%CI：0.71至0.89，I2=9.7%，NNT：10）。
结论：在春季每天服用400至1200IU/d的维生素D补充剂可能会稍微预防ARIs，秋天,或者冬天，这应该在未来的临床试验中进一步研究。
