Vitamin D supplementation requires calcium to prevent fractures

January 01, 0001

Vitamin D supplementation requires calcium to prevent fractures

These European and US investigators sought to identify patients’ characteristics and dosing regimens that affect the fracture prevention efficacy of vitamin D. Individual patient data analysis was pooled from seven major randomised trials of vitamin D (68,517 participants) and logistic regression analysis and Cox proportional hazards models were used.

The investigators found: "Trials using vitamin D with calcium showed a reduced overall risk of fracture (hazard ratio 0.92) and hip fracture (all studies- 0.84, studies using 10 µg of vitamin D given with calcium- 0.74). For vitamin D alone in daily doses of 10 µg or 20 µg, no significant effects were found. No interaction was found between fracture history and treatment response, nor any interaction with age, sex, or hormone replacement therapy."

The investigators concluded: "This individual patient data analysis indicates that vitamin D given alone in doses of 10-20 mcg is not effective in preventing fractures. By contrast, calcium and vitamin D given together reduce hip fractures and total fractures, and probably vertebral fractures, irrespective of age, sex, or previous fractures."

This study demonstrates both the importance of co- administration of calcium with vitamin D for bone health and its applicability in a wide spectrum of patients.

For the full abstract, click here.

BMJ 340 (121): b5463, 16 January 2010 © 2010 The DIPART Group
Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. The DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group. Correspondence to B Abrahamsen: [email protected]

Category: M Musculoskeletal, T Endocrine/Metabolic/Nutritional, Keywords: Vitamin D, Calcium, hip fracture, vertebral fracture, DIPART, individual patient data analysis using pooled data from randomized trials, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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