■维生素D补充剂可能仅对预防骨质疏松性骨折有益钙和25(OH)D低血液水平的个体,但不能排除补钙对CVD的可能危害。
我们对所有安慰剂对照的随机试验进行了荟萃分析,以评估钙补充剂单独或与维生素D一起使用对冠心病的影响。中风,和全因死亡率。
■11项试验的荟萃分析包括7项单独钙与对照组的比较(n=8634)和6项钙加维生素D与对照组的比较(n=46,804)。汇总的研究水平数据来自单个试验,并使用固定效应荟萃分析进行组合。主要结果包括MI,冠心病死亡,任何CHD,中风,和全因死亡率。
■在单独使用钙的试验中(平均日剂量1g),钙与MI的任何额外风险没有显着相关(RR,1.15;95%CI:0.88,1.51;n=219个事件),冠心病死亡(RR,1.24;95%CI:0.89,1.73;n=142),任何冠心病(RR,1.01;95%CI:0.75,1.37;n=177),或中风(RR,1.15;95%CI,0.90,1.46,n=275)。在6项联合治疗试验中,补充钙加维生素D与MI的任何额外风险没有显着相关(RR,1.09;95%CI:0.95,1.25;n=854),冠心病死亡(RR,1.04;95%CI:0.85,1.27;n=391),任何冠心病(RR,1.05;95%CI:0.93,1.19;n=1061),或中风(RR,1.02;95%CI:0.89,1.17;n=885)。同样,单独的钙,或维生素D与全因死亡率无显著关联.
■这项荟萃分析表明,钙补充剂与冠心病的任何重大危险无关。中风,或全因死亡率,并排除冠心病或卒中每年超过0.3%-0.5%的超额风险。在25(OH)D低血液水平的个体中需要进一步的钙和维生素D试验,以预防骨折和其他疾病的后果。
UNASSIGNED: Vitamin D supplements may only be beneficial for the prevention of osteoporotic fractures when administered with calcium and in individuals with low blood levels of 25(OH)D, but possible hazards of calcium supplements on CVD cannot be excluded.
UNASSIGNED: We conducted a meta-analysis of all placebo-controlled randomized trials assessing the effects of calcium supplements alone or with vitamin D on CHD, stroke, and all-cause mortality.
UNASSIGNED: A meta-analysis of 11 trials included 7 comparisons of calcium alone compared with control (n = 8634) and 6 comparisons of calcium plus vitamin D compared with control (n = 46,804). Aggregated study-level data were obtained from individual trials and combined using a fixed-effects meta-analysis. The main outcomes included MI, CHD death, any CHD, stroke, and all-cause mortality.
UNASSIGNED: Among trials of calcium alone (mean daily dose 1 g), calcium was not significantly associated with any excess risk of MI (RR, 1.15; 95% CI: 0.88, 1.51; n = 219 events), CHD death (RR, 1.24; 95% CI: 0.89, 1.73; n = 142), any CHD (RR, 1.01; 95% CI: 0.75, 1.37; n = 177), or stroke (RR, 1.15; 95% CI, 0.90, 1.46, n = 275). Among 6 trials of combined treatment, supplementation with calcium plus vitamin D was not significantly associated with any excess risk of MI (RR, 1.09; 95% CI: 0.95, 1.25; n = 854), CHD death (RR, 1.04; 95% CI: 0.85, 1.27; n = 391), any CHD (RR, 1.05; 95% CI: 0.93, 1.19; n = 1061), or stroke (RR, 1.02; 95% CI: 0.89, 1.17; n = 885). Likewise, calcium alone, or with vitamin D had no significant associations with all-cause mortality.
UNASSIGNED: This meta-analysis demonstrated that calcium supplements were not associated with any significant hazard for CHD, stroke, or all-cause mortality and excluded excess risks above 0.3%-0.5% per year for CHD or stroke. Further trials of calcium and vitamin D are required in individuals with low blood levels of 25(OH)D for the prevention of fracture and other disease outcomes.