Vitamin D Supplementation and Fractures in Adults
| Autor: | Aya Bassatne, Stephanie Antoun, Sara Ajjour, Marlene Chakhtoura, Elie A. Akl, Dania S Bacha, Ghada El-Hajj Fuleihan, Roger Bouillon, Charbel Gharios, Peter R. Ebeling, Mariam Assaad, Francesca Kahale, Yara Jabbour, Paul Lips |
|---|---|
| Přispěvatelé: | Internal medicine, APH - Aging & Later Life |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Endocrinology Diabetes and Metabolism Clinical Biochemistry Context (language use) Placebo Biochemistry Fractures Bone Endocrinology Meta-Analysis as Topic Umbrella Review Internal medicine medicine Vitamin D and neurology Humans Adults Vitamin D Randomized Controlled Trials as Topic Intention-to-treat analysis Bone Density Conservation Agents Vitamin d supplementation business.industry Individual participant data Biochemistry (medical) Treatment Outcome Systematic review Relative risk Dietary Supplements business Fractures Systematic Reviews as Topic |
| Zdroj: | The Journal of clinical endocrinology and metabolism, 107(3), 882-898. The Endocrine Society Chakhtoura, M, Bacha, D S, Gharios, C, Ajjour, S, Assaad, M, Jabbour, Y, Kahale, F, Bassatne, A, Antoun, S, Akl, E A, Bouillon, R, Lips, P, Ebeling, P R & el-Hajj Fuleihan, G 2022, ' Vitamin D Supplementation and Fractures in Adults : A Systematic Umbrella Review of Meta-Analyses of Controlled Trials ', The Journal of clinical endocrinology and metabolism, vol. 107, no. 3, pp. 882-898 . https://doi.org/10.1210/clinem/dgab742 |
| ISSN: | 0021-972X |
| Popis: | Context The growing number of systematic reviews/meta-analyses (SR/MAs) on vitamin D (± calcium) for fracture prevention has led to contradictory guidelines. Objective This umbrella review aims to assess the quality and explore the reasons for the discrepancy of SR/MAs of trials on vitamin D supplementation for fracture risk reduction in adults. Methods We searched 4 databases (2010-2020), Epistemonikos, and references of included SRs/MAs, and we contacted experts in the field. We used A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) for quality assessment. We compared results and investigated reasons for discordance using matrices and subgroup analyses (PROSPERO registration: CRD42019129540). We included 13 SR/MAs on vitamin D and calcium (Ca/D) and 19 SR/MAs on vitamin D alone, compared to placebo/control. Results Only 2 from 10 SRs/MAs on Ca/D were of moderate quality. Ca/D reduced the risk of hip fractures in 8 of 12 SRs/MAs (relative risk [RR] 0.61-0.84), and any fractures in 7 of 11 SR/MAs (RR 0.74-0.95). No fracture risk reduction was noted in SRs/MAs exclusively evaluating community-dwelling individuals or in those on vitamin D alone compared to placebo/control. Discordance in results between SRs/MAs stems from inclusion of different trials, related to search periods and eligibility criteria, and varying methodology (using intention to treat, per-protocol, or complete case analysis from individual trials). Conclusion Ca/D reduces the risk of hip and any fractures, possibly driven by findings from institutionalized individuals. Individual participant data meta-analyses of patients on Ca/D with sufficient follow-up periods, and subgroup analyses, would unravel determinants for a beneficial response to supplementation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|