Vitamin D und Sterblichkeit: Metaanalyse

Diese Metaanalyse zu „Vitamin D und Sterblichkeit: Metaanalyse“ bündelt Originalarbeiten und ordnet deren Aussagekraft sowie Grenzen ein.

Welche Frage wurde untersucht?

Die Arbeit „Association between vitamin D supplementation and mortality: systematic review and meta-analysis“ prüft, wie Vitamin-D-Status oder Supplementierung mit dem im Titel bezeichneten Endpunkt zusammenhängen. Entscheidend ist die Ebene der Evidenz: Hier wird nicht eine einzelne Beobachtung, sondern eine systematisch zusammengeführte Studienlage betrachtet.

Wie wurde die Evidenz zusammengeführt?

Die Arbeit führt Ergebnisse mehrerer Studien zusammen. Die Quellenliste dokumentiert die zugeordneten Originalarbeiten. Die Zusammenführung erhöht die Datenbasis, beseitigt aber Unterschiede bei Population, Ausgangsstatus, Vergleich, Dosisregime und Endpunktdefinition nicht.

Was zeigt der Gesamtbefund?

Vitamin-D-Supplementierung allein senkte in der Metaanalyse die Gesamtsterblichkeit nicht signifikant. Für Krebstodesfälle zeigte sich dagegen ein relatives Risikosignal zugunsten der Supplementierung.

Der Befund beschreibt genau den untersuchten Vergleich. Er darf nicht als allgemeines Wirkversprechen für Vitamin D oder als Empfehlung für eine bestimmte Einnahmemenge gelesen werden.

Wie belastbar ist das Ergebnis?

Der sekundäre Befund zu Krebstodesfällen muss zusammen mit Studiendesign, Endpunktwahl und ausstehender Bestätigung gelesen werden. Metaanalysen übernehmen zudem die Grenzen ihrer eingeschlossenen Studien. Heterogenität, Bias und unterschiedliche Messweisen können einen gepoolten Wert beeinflussen.

Einordnung für Supplement Stack

Der Artikel dokumentiert die gemeinsam ausgewertete Studienlage samt Originalquellen. Die stoffweite Einordnung zu Versorgung, Referenzwerten und Sicherheit steht im Vitamin D: Warum Sonne, Knochen und Calcium zusammengehören.

Fazit

Vitamin-D-Supplementierung allein senkte in der Metaanalyse die Gesamtsterblichkeit nicht signifikant. Für Krebstodesfälle zeigte sich dagegen ein relatives Risikosignal zugunsten der Supplementierung. Für die praktische Einordnung bleibt die genannte Grenze wesentlich: Der sekundäre Befund zu Krebstodesfällen muss zusammen mit Studiendesign, Endpunktwahl und ausstehender Bestätigung gelesen werden.

Quellen

  1. Lips et al. (1996). Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med. DOI: 10.7326/0003-4819-124-4-199602150-00003. PMID: 8554248.
  2. Flicker et al. (2005). Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc. DOI: 10.1111/j.1532-5415.2005.00468.x. PMID: 16274368.
  3. Lappe et al. (2007). Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. DOI: 10.1093/ajcn/85.6.1586. PMID: 17556697.
  4. Schleithoff et al. (2006). Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial.. Am J Clin Nutr. DOI: 10.1093/ajcn/83.4.754. PMID: 16600924.
  5. Witham MD, Crighton LJ, Gillespie ND et al. (2010). The effects of vitamin D supplementation on physical function and quality of life in older patients with heart failure: a randomized controlled trial. Circ Heart Fail. DOI: 10.1161/circheartfailure.109.907899. PMID: 20103775.
  6. Avenell et al. (2012). Long-term follow-up for mortality and cancer in a randomized placebo-controlled trial of vitamin D(3) and/or calcium (RECORD trial). J Clin Endocrinol Metab. DOI: 10.1210/jc.2011-1309. PMID: 22112804.
  7. Arden NK, Cro S, Sheard S (2016). The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage. DOI: 10.1016/j.joca.2016.05.020. PMID: 27264058.
  8. Cherniack EP, Florez HJ, Hollis BW et al. (2011). The response of elderly veterans to daily vitamin D3 supplementation of 2,000 IU: a pilot efficacy study. J Am Geriatr Soc. DOI: 10.1111/j.1532-5415.2010.03242.x. PMID: 21288233.
  9. Latham et al. (2003). A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc. DOI: 10.1046/j.1532-5415.2003.51101.x. PMID: 12588571.
  10. Harwood et al. (2004). A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NoNOF) Study. Age Ageing. DOI: 10.1093/ageing/afh002. PMID: 14695863.
  11. Zhang et al. (2019). Association between vitamin D supplementation and mortality: systematic review and meta-analysis. BMJ. DOI: 10.1136/bmj.l4673. PMID: 31405892.
  12. Janssen HC, Samson MM, Verhaar HJ (2010). Muscle strength and mobility in vitamin D-insufficient female geriatric patients: a randomized controlled trial on vitamin D and calcium supplementation. Aging Clin Exp Res. DOI: 10.1007/bf03324819. PMID: 20305368.
  13. Sanders et al. (2010). Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. DOI: 10.1001/jama.2010.594. PMID: 20460620.
  14. Martineau AR, James WY, Hooper RL (2015). Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. DOI: 10.1016/s2213-2600(14)70255-3. PMID: 25476069.
  15. Jorde et al. (2016). Vitamin D 20,000 IU per week for five years does not prevent progression from prediabetes to diabetes. J Clin Endocrinol Metab. DOI: 10.1210/jc.2015-4013. PMID: 26829443.
  16. Inkovaara et al. (1983). Calcium, vitamin D and anabolic steroid in treatment of aged bones: double-blind placebo-controlled long-term clinical trial. Age Ageing. DOI: 10.1093/ageing/12.2.124. PMID: 6346829.
  17. Bischoff et al. (2003). Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. DOI: 10.1359/jbmr.2003.18.2.343. PMID: 12568412.
  18. Baron et al. (2015). A trial of calcium and vitamin D for the prevention of colorectal adenomas.. N Engl J Med. DOI: 10.1056/nejmoa1500409. PMID: 26465985.
  19. Law et al. (2006). Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing. DOI: 10.1093/ageing/afj080. PMID: 16641143.
  20. Corless et al. (1985). Do vitamin D supplements improve the physical capabilities of elderly hospital patients?. Age Ageing. DOI: 10.1093/ageing/14.2.76. PMID: 4003187.
  21. Burleigh et al. (2007). Does vitamin D stop inpatients falling? A randomised controlled trial. Age Ageing. DOI: 10.1093/ageing/afm087. PMID: 17656420.
  22. Trivedi et al. (2003). Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. DOI: 10.1136/bmj.326.7387.469. PMID: 12609940.
  23. Scragg et al. (2017). Effect of Monthly High-Dose Vitamin D Supplementation on Cardiovascular Disease in the Vitamin D Assessment Study: A Randomized Clinical Trial. JAMA Cardiology. DOI: 10.1001/jamacardio.2017.0175. PMID: 28384800.
  24. Hin H, Tomson J, Newman C (2017). Optimum dose of vitamin D for disease prevention in older people: BEST-D trial of vitamin D in primary care. Osteoporos Int. DOI: 10.1007/s00198-016-3833-y. PMID: 27986983.
  25. Lyons et al. (2007). Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled trial of vitamin D supplementation. Osteoporos Int. DOI: 10.1007/s00198-006-0309-5. PMID: 17473911.
  26. Jin X, Jones G, Cicuttini F (2016). Effect of vitamin D supplementation on tibial cartilage volume and knee pain among patients with symptomatic knee osteoarthritis: a randomized clinical trial. JAMA. DOI: 10.1001/jama.2016.1961. PMID: 26954409.
  27. Zittermann et al. (2017). Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000?IU vitamin D daily.. Eur Heart J. DOI: 10.1093/eurheartj/ehx235. PMID: 28498942.
  28. Lehouck et al. (2012). High doses of vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial.. Ann Intern Med. DOI: 10.7326/0003-4819-156-2-201201170-00004. PMID: 22250141.
  29. Uusi-Rasi K, Patil R, Karinkanta S (2015). Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. JAMA Intern Med. DOI: 10.1001/jamainternmed.2015.0225. PMID: 25799402.
  30. Grimnes G, Figenschau Y, Almås B et al. (2011). Vitamin D, insulin secretion, sensitivity, and lipids: results from a case-control study and a randomized controlled trial using hyperglycemic clamp technique. Diabetes. DOI: 10.2337/db11-0650. PMID: 21911741.
  31. Witte KK, Byrom R, Gierula J (2016). Effects of vitamin D on cardiac function in patients with chronic HF: the VINDICATE study. J Am Coll Cardiol. DOI: 10.1016/j.jacc.2016.03.508. PMID: 27058906.
  32. Aloia et al. (2005). A randomized controlled trial of vitamin D-3 supplementation in African American women. Arch Intern Med. DOI: 10.1001/archinte.165.14.1618. PMID: 16043680.
  33. Witham et al. (2013). Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial.. JAMA Intern Med. DOI: 10.1001/jamainternmed.2013.9043. PMID: 23939263.
  34. Chel et al. (2008). Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents. Osteoporos Int. DOI: 10.1007/s00198-007-0465-2. PMID: 17874029.
  35. Smith et al. (2007). Effect of annual intramuscular vitamin D on fracture risk in elderly men and women--a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford). DOI: 10.1093/rheumatology/kem240. PMID: 17998225.
  36. Cooper et al. (2003). Vitamin D supplementation and bone mineral density in early postmenopausal women. Am J Clin Nutr. DOI: 10.1093/ajcn/77.5.1324. PMID: 12716689.
  37. Brohult et al. (1973). Effects of large doses of calciferol on patients with rheumatoid arthritis. A double-blind clinical trial. Scand J Rheumatol. DOI: 10.3109/03009747309097085. PMID: 4129296.
  38. Broe et al. (2007). A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc. DOI: 10.1111/j.1532-5415.2007.01048.x. PMID: 17302660.
  39. Glendenning et al. (2012). Effects of three-monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: a randomized controlled trial. J Bone Miner Res. DOI: 10.1002/jbmr.524. PMID: 21956713.
  40. Rizzoli R, Dawson-Hughes B, Kaufman JM (2014). Correction of vitamin D insufficiency with combined strontium ranelate and vitamin D3 in osteoporotic patients. Eur J Endocrinol. DOI: 10.1530/eje-13-0775. PMID: 24322182.
  41. Hansen KE, Johnson RE, Chambers KR (2015). Treatment of vitamin D insufficiency in postmenopausal women: a randomized clinical trial. JAMA Intern Med. DOI: 10.1001/jamainternmed.2015.3874. PMID: 26237520.
  42. Manson et al. (2019). Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. The New England Journal of Medicine. DOI: 10.1056/nejmoa1809944. PMID: 30415629.
  43. Akiba T, Morikawa T, Odaka M (2018). Vitamin D supplementation and survival of patients with non-small cell lung cancer: a randomized, double-blind, placebo-controlled trial. Clin Cancer Res. DOI: 10.1158/1078-0432.ccr-18-0483. PMID: 30018118.
  44. Meyer et al. (2002). Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res. DOI: 10.1359/jbmr.2002.17.4.709. PMID: 11918228.
  45. Massart A, Debelle FD, Racapé J (2014). Biochemical parameters after cholecalciferol repletion in hemodialysis: results grom the VitaDial randomized trial. Am J Kidney Dis. DOI: 10.1053/j.ajkd.2014.04.020. PMID: 24856872.
  46. Punthakee Z, Bosch J, Dagenais G (2012). Design, history and results of the Thiazolidinedione Intervention with vitamin D Evaluation (TIDE) randomised controlled trial. Diabetologia. DOI: 10.1007/s00125-011-2357-4. PMID: 22038523.
  47. Prince et al. (2008). Effects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women. Arch Intern Med. DOI: 10.1001/archinternmed.2007.31. PMID: 18195202.
  48. Lips et al. (2010). Once-weekly dose of 8400 IU vitamin D(3) compared with placebo: effects on neuromuscular function and tolerability in older adults with vitamin D insufficiency. Am J Clin Nutr. DOI: 10.3945/ajcn.2009.28113. PMID: 20130093.
  49. Levis S, Gómez-Marín O (2017). Vitamin D and physical function in sedentary older men. J Am Geriatr Soc. DOI: 10.1111/jgs.14510. PMID: 27861700.
  50. Zhu et al. (2008). Effects of calcium and vitamin D supplementation on hip bone mineral density and calcium-related analytes in elderly ambulatory Australian women: a five-year randomized controlled trial. J Clin Endocrinol Metab. DOI: 10.1210/jc.2007-1466. PMID: 18089701.
  51. Owusu JE, Islam S, Katumuluwa SS (2019). Cognition and vitamin D in older African-American women: physical performance and osteoporosis prevention with vitamin D in older African Americans trial and dementia. J Am Geriatr Soc. DOI: 10.1111/jgs.15607. PMID: 30359476.