Meta-analysis of the efficacy of combined therapy vitamin D with calcium in nutritional rickets

Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, （CBM）,Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-（ OH） ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence （ WMD） and 95% confidence interval （ CI） for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that：（1）the increase of Serum 25-（OH）vitamin D：Combined therapy group and vitamin D group （MD= -7. 88,95%CI：-12. 24- -3. 52）;Combined therapy group and calcium group （MD= -18. 32,95%CI：-22. 61- -14. 04）. （2）the increase of serum phosphate：Combined therapy group and vitamin D group （ MD= -0. 64 （ 95%CI：-0. 86 - -0. 42 ）;Combined therapy group and calcium group MD= -0. 16 （ 95%CI：-0. 84 -0. 51 ） . （ 3 ） the decrease of Serum ALP：Combined therapy group and vitamin D group （MD= 109. 99,95%CI：20. 40 -199. 58）;Combined therapy group and calcium group （MD=59. 89,95%CI：10. 09-109. 59 ）. （4）the increase of serum calcium ：Combined therapy group and vitamin D group （MD= -0. 71,95%CI：-0. 91,-0. 52）;the decrease of Radiographic score：Com-bined therapy group and vitamin D group（ MD=0. 68,95%CI：0. 42- 0. 95）. Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group. Key words: Vitamin D;  Calcium;  Rickets;  Meta-analysis