Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
By A. Martineau, David A. Jolliffe, R. Hooper, L. Greenberg, J. Aloia, P. Bergman, G. Dubnov-Raz, S. Esposito, D. Ganmaa, A. Ginde and 15 more. British medical journal, 2017
1,750 citations recorded by the source corpus.
Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect. Design Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials. Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015. Eligibility criteria for study selection Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome. Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96.6%) participants. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity <0.001). In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses (adjusted odds ratio 0.81, 0.72 to 0.91) but not in those receiving one or more bolus doses (adjusted odds ratio 0.97, 0.86 to 1.10; P for interaction=0.05). Among those receiving daily or weekly vitamin D, protective effects were stronger in those with baseline 25-hydroxyvitamin D levels <25 nmol/L (adjusted odds ratio 0.30, 0.17 to 0.53) than in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (adjusted odds ratio 0.75, 0.60 to 0.95; P for interaction=0.006). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted odds ratio 0.98, 0.80 to 1.20, P=0.83). The body of evidence contributing to these analyses was assessed as being of high quality. Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit. Systematic review registration PROSPERO CRD42014013953.
Subfields: Nutrition and Dietetics, Pathology and Forensic Medicine, Pulmonary and Respiratory Medicine
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Citations in the corpus
- Conducting systematic literature reviews and bibliometric analyses (2019, background): “A detailed example of a search strategy is the review of Vitamin D supplementation by Martineau et al. (2017) – the researchers provide a supplementary appendix that details the specific search strategies and search terms used to uncover a comprehensive set of studies from various databases and…”
- A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection (2020, positive): “Better results were achieved in those with a low vitamin D status at the start of the trial [120,193], with a lower odds ratio for risk reduction with low (0.”
- Vitamin D deficiency 2.0: an update on the current status worldwide (2020, background): “A cutoff of <25 or <30 nmol/L (or 10/12 ng/ml) increases the risk of osteomalacia and nutritional rickets dramatically, and therefore is considered to determine severe vitamin D deficiency [13] [14] [15] [16] .”