{"title":"预防急性呼吸道感染的最佳维生素 D 补充方法：随机对照试验的系统回顾、剂量反应和配对荟萃分析。","authors":"Chih-Hung Wang, Lorenzo Porta, Ting-Kai Yang, Yu-Hsiang Wang, Tsung-Hung Wu, Frank Qian, Yin-Yi Han, Wang-Huei Sheng, Shyr-Chyr Chen, Chien-Chang Lee, Shan-Chwen Chang","doi":"10.1186/s12937-024-00990-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, I<sup>2</sup> = 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, I<sup>2</sup> = 55.7%, number needed to treat [NNT]: 36), trials duration < 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, I<sup>2</sup> = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, I<sup>2</sup> = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, I<sup>2</sup> = 9.7%, NNT: 10).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"23 1","pages":"92"},"PeriodicalIF":4.4000,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323636/pdf/","citationCount":"0","resultStr":"{\"title\":\"Optimal methods of vitamin D supplementation to prevent acute respiratory infections: a systematic review, dose-response and pairwise meta-analysis of randomized controlled trials.\",\"authors\":\"Chih-Hung Wang, Lorenzo Porta, Ting-Kai Yang, Yu-Hsiang Wang, Tsung-Hung Wu, Frank Qian, Yin-Yi Han, Wang-Huei Sheng, Shyr-Chyr Chen, Chien-Chang Lee, Shan-Chwen Chang\",\"doi\":\"10.1186/s12937-024-00990-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, I<sup>2</sup> = 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, I<sup>2</sup> = 55.7%, number needed to treat [NNT]: 36), trials duration < 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, I<sup>2</sup> = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, I<sup>2</sup> = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, I<sup>2</sup> = 9.7%, NNT: 10).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":19203,\"journal\":{\"name\":\"Nutrition Journal\",\"volume\":\"23 1\",\"pages\":\"92\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323636/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nutrition Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12937-024-00990-w\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12937-024-00990-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
背景：补充维生素 D 可预防急性呼吸道感染（ARI）：补充维生素 D 可预防急性呼吸道感染（ARI）。本研究旨在确定补充维生素 D 的最佳方法：方法：对 PubMed、Embase、Cochrane Central Register of Controlled Trials、Web of Science 和 ClinicalTrials.gov 注册表进行了检索，检索时间从数据库开始至 2023 年 7 月 13 日。纳入了随机对照试验（RCT）。采用随机效应模型对数据进行了汇总。主要结果是出现一次或多次ARI的参与者比例：分析包括 43 项随机对照试验，共有 49320 名参与者。40项研究被认为偏倚风险较低。主要的配对荟萃分析表明，补充维生素 D 对预防急性呼吸道感染没有显著效果（风险比 [RR]：0.99，95% 置信区间：0.99，95% 置信区间：0.99）：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，夏季和冬季亚组的最佳维生素 D 补充剂量介于 400-1200 IU/天之间。亚组配对荟萃分析还显示，在每日剂量的亚组中，维生素 D 补充剂具有显著的预防效果（RR：0.92，95% CI：0.85 至 0.99，I2 = 55.7%，治疗所需人数 [NNT]：结论：维生素 D 补充剂可轻微缓解甲状腺肿大（RR：0.92，95% CI：0.85 至 0.99，I2 = 55.7%，治疗所需人数[NNT]：36）、试验持续时间 2 = 48.8%，NNT：16）、夏季缓解季节（RR：0.85，95% CI：0.74 至 0.98，I2 = 55.8%，治疗所需人数[NNT]：26）和冬季缓解季节（RR：0.79，95% CI：0.71 至 0.89，I2 = 9.7%，治疗所需人数[NNT]：10）：结论：在春季、秋季或冬季，每天服用 400 至 1200 IU 的维生素 D 补充剂可轻微预防急性呼吸道感染。
Optimal methods of vitamin D supplementation to prevent acute respiratory infections: a systematic review, dose-response and pairwise meta-analysis of randomized controlled trials.
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).
Conclusion: 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.
期刊介绍：
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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