使用高濃度維他命D營養補充品與發生尿路結石之風險

統合分析與系統性文獻回顧

黃品叡、陳丕哲、沈正煌、林昌德、鄭明進

戴德森醫療財團法人嘉義基督教醫院 外科部 泌尿科

A Meta-analysis and Systematic Review of the Correlation between the Outcome of Urolithiasis and High-dose Vitamin D supplementation

Pin-Jui Huang, Pi-Che Chen, Cheng-Huang Shen, Chang-Te Lin, Ming-Chin Cheng

Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan

Introduction:

Vitamin D is a nutritional supplement that has received special attention in recent years , and its common functions include maintaining proper blood calcium and phosphorus levels in the body, regulating cell growth, neuromuscular and immune functions. But the serious side effect of taking too much vitamin D is to increase the blood calcium concentration, and there is a risk of developing urinary tract stones. This study hopes to use an empirical method to compare the relationship between the results of using high-concentration vitamin D nutritional supplements and the risk of urinary calculi, so as to serve as a consideration for clinical and public choice of vitamin D nutritional supplements .

Method:

Set PICO and use keywords such as Vitamin D supplementation, urolithiasis, etc., use MeSH term and Bollinger logic to search and retrieve in databases such as PubMed, Cochrane library, Airiti Library, etc. 75 articles, excluding duplication, inconformity with the research purpose, and inconsistency with the theme of PICO, finally included 3 randomized controlled trials, all of which were Level II according to the 2011 Oxford Center for Empirical Medicine, and CASP was used for literature review .

Result:

A total of 43,761 people were involved in the above 3 documents, and the meta-analyzed by the meta- analysis software Review Manager (version 5.4). The utility of high-concentration vitamin D nutritional supplements was associated with a higher risk of urolithiasis compared with a control group (Placebo). The relative risk (RR) is 1.13, (95% c.i. 1.00 to 1.28, p  = 0.05, I² = 3 %), which indicate low heterogeneity .

Conclusion:

According to literature review and meta-analysis, high-concentration vitamin D nutritional supplements are associated with a higher risk of urinary calculi. Although the result shows there is no statistical significance (p  = 0.05), the relative risk ratio still indicates a higher probability of urolithiasis in Vitamin D nutritional supplements group. Among them, there are differences in different literatures because of the numerical definition of high concentration , the number of years of supplementary use, the co-morbid groups of different ages , and the diagnosis basis of stones . More rigorous randomized studies are still needed to verify the integrity of the follow-up.