維他命D可降低老年人骨折的風險


  Feb. 27, 2003 - 3月1日出刊的「英國醫學期刊(British Medical Journal)」報導,根據一項隨機、雙盲的控制試驗結果顯示, 65 ~ 85歲的社區居民每4個月口服補充一次維他命D,可減少5年之後骨折的危險。
  
  英國劍橋大學Daksha P. Trivedi表示,老年人需要安全、有效、合宜,且費用便宜的骨折預防方法。
  
  研究樣本包括2,686人(2,037位男性與649位女性),年齡介於65 ~ 85歲之間的社區居民,研究人員每4個月會郵寄1顆100,000國際單位(IU)的維他命D3(cholecalciferol)膠囊或安慰劑給這些受試的社區居民,並讓他們持續服用5年(總共15顆)。
  
  結果5年後共有268位受試者骨折,其中147位為髖關節、腕關節、前臂或脊椎骨折,這些也都是骨質疏鬆症常見的骨折部位。與安慰劑組比較,服用維他命D3的受試者首次發生任何部位骨折的機率減少22%(相對風險,0.78;95%信賴區間,0.61 - 0.99;P = .04),而發生髖關節、腕關節、前臂或脊椎骨折的機率也少了33%(相對風險,0.67;95%信賴區間,0.48 - 0.93;P = . 02)。
  
  許多對高危險群有效的醫療或預防方法卻可能因為服從性不夠、副作用或費用的因素而不適合一般人,相對來說,每四個月服用1顆100,000國際單位的維他命D是最便宜的預防方法了(每年不到1英鎊)。

Vitamin D Reduces Fractures in

By Laurie Barclay, MD
Medscape Medical News

Feb. 27, 2003 — Over the course of five years, supplementing with oral vitamin D every four months reduced the fracture rate in community dwellers aged 65 to 85 years, according to the results of a randomized, double-blind controlled trial reported in the March 1 issue of the British Medical Journal.

"Safe, effective, feasible, and cost effective primary prevention measures are needed in older men and women, in whom most osteoporotic fractures occur," write Daksha P. Trivedi, and colleagues from the University of Cambridge in the U.K.

The study sample consisted of 2,686 people (2,037 men and 649 women), aged 65 to 85 years, living in the community. Investigators mailed each subject one capsule containing 100,000 IU vitamin D3 (cholecalciferol) or placebo every four months for five years (15 doses total).

After five years, 268 subjects had fractures, including 147 fractures of the hip, wrist, forearm, or vertebrae, which are common sites for osteoporosis. Compared with the placebo group, the vitamin D group had a 22% lower rate for first fracture at any site (relative risk [RR], 0.78; 95% confidence interval [CI], 0.61 - 0.99; P = .04) and a 33% lower rate for a fracture occurring in the hip, wrist, forearm, or vertebrae (RR, 0.67; 95% CI, 0.48 - 0.93; P = .02).

"Many interventions effective in high risk groups are not feasible in the general population owing to poor compliance or side effects or are not cost effective," the authors write. "In contrast, the cost of four monthly oral 100,000 IU vitamin D is minimal (less than £1 annually)."

BMJ. 2003;326:469-472

Reviewed by Gary D. Vogin, MD

    
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