Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation View Full Text


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Article Info

DATE

2015-10-28

AUTHORS

C. M. Weaver, D. D. Alexander, C. J. Boushey, B. Dawson-Hughes, J. M. Lappe, M. S. LeBoff, S. Liu, A. C. Looker, T. C. Wallace, D. D. Wang

ABSTRACT

The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87).IntroductionCalcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults.MethodsA PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran’s Q test and the I2 statistic, and potential for publication bias was assessed.ResultsOf the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women’s Health Initiative.ConclusionsThis meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults. More... »

PAGES

367-376

References to SciGraph publications

  • 2012-12-04. Health risks and benefits from calcium and vitamin D supplementation: Women's Health Initiative clinical trial and cohort study in OSTEOPOROSIS INTERNATIONAL
  • 2014-03-27. Calcium Supplementation: Is Protecting Against Osteoporosis Counter to Protecting against Cardiovascular Disease? in CURRENT OSTEOPOROSIS REPORTS
  • 2011-12-09. Prevention of falls and fractures in old people by administration of calcium and vitamin d. randomized clinical trial in BMC PUBLIC HEALTH
  • 2014-01-17. Effect of calcium phosphate and vitamin D3supplementation on bone remodelling and metabolism of calcium, phosphorus, magnesium and iron in NUTRITION JOURNAL
  • 2010-12-14. Calcium and vitamin D supplementation through fortified dairy products counterbalances seasonal variations of bone metabolism indices: the Postmenopausal Health Study in EUROPEAN JOURNAL OF NUTRITION
  • 2002-03. Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study in OSTEOPOROSIS INTERNATIONAL
  • 2012-05-30. High-calcium, vitamin D fortified milk is effective in improving bone turnover markers and vitamin D status in healthy postmenopausal Chinese women in EUROPEAN JOURNAL OF CLINICAL NUTRITION
  • 2011-01-20. Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture in THE JOURNAL OF NUTRITION, HEALTH & AGING
  • 2011-04-01. Possible site-specific effect of an intervention combining nutrition and lifestyle counselling with consumption of fortified dairy products on bone mass: the Postmenopausal Health Study II in JOURNAL OF BONE AND MINERAL METABOLISM
  • 2011-11-16. Is a daily supplementation with 40 microgram vitamin D3 sufficient? A randomised controlled trial in EUROPEAN JOURNAL OF NUTRITION
  • Journal

    TITLE

    Osteoporosis International

    ISSUE

    1

    VOLUME

    27

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00198-015-3386-5

    DOI

    http://dx.doi.org/10.1007/s00198-015-3386-5

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26510847


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    27 schema:description The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87).IntroductionCalcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults.MethodsA PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran’s Q test and the I2 statistic, and potential for publication bias was assessed.ResultsOf the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73–0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56–0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women’s Health Initiative.ConclusionsThis meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.
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    50 bias
    51 calcium
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    59 estimates
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