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Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data

Citation

Martineau, AR and Jolliffe, DA and Hooper, RL and Greenberg, L and Aloia, JF and Bergman, P and Dubnov-Raz, G and Esposito, S and Ganmaa, D and Ginde, AA and Goodall, EC and Grant, CC and Griffiths, CJ and Janssens, W and Laaksi, I and Manaseki-Holland, S and Mauger, D and Murdoch, DR and Neale, R and Rees, JR and Simpson Jr, S and Stelmach, I and Kumar, GT and Urashima, M and Camargo, CA, Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data, BMJ, 356 Article i6583. ISSN 1756-1833 (2017) [Refereed Article]


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DOI: doi:10.1136/bmj.i6583

Abstract

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.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
Author:Simpson Jr, S (Dr Steve Simpson JR)
ID Code:115380
Year Published:2017
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-03-21
Last Modified:2017-03-21
Downloads:0

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