Document Detail


A pooled analysis of vitamin D dose requirements for fracture prevention.
MedLine Citation:
PMID:  22762317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction have been inconsistent.
METHODS: We pooled participant-level data from 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, as compared with placebo or calcium alone in persons 65 years of age or older. Primary end points were the incidence of hip and any nonvertebral fractures according to Cox regression analyses, with adjustment for age group, sex, type of dwelling, and study. Our primary aim was to compare data from quartiles of actual intake of vitamin D (including each individual participant's adherence to the treatment and supplement use outside the study protocol) in the treatment groups of all trials with data from the control groups.
RESULTS: We included 31,022 persons (mean age, 76 years; 91% women) with 1111 incident hip fractures and 3770 nonvertebral fractures. Participants who were randomly assigned to receive vitamin D, as compared with those assigned to control groups, had a nonsignificant 10% reduction in the risk of hip fracture (hazard ratio, 0.90; 95% confidence interval [CI], 0.80 to 1.01) and a 7% reduction in the risk of nonvertebral fracture (hazard ratio, 0.93; 95% CI, 0.87 to 0.99). By quartiles of actual intake, reduction in the risk of fracture was shown only at the highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30% reduction in the risk of hip fracture (hazard ratio, 0.70; 95% CI, 0.58 to 0.86) and a 14% reduction in the risk of any nonvertebral fracture (hazard ratio, 0.86; 95% CI, 0.76 to 0.96). Benefits at the highest level of vitamin D intake were fairly consistent across subgroups defined by age group, type of dwelling, baseline 25-hydroxyvitamin D level, and additional calcium intake.
CONCLUSIONS: High-dose vitamin D supplementation (≥800 IU daily) was somewhat favorable in the prevention of hip fracture and any nonvertebral fracture in persons 65 years of age or older. (Funded by the Swiss National Foundations and others.).
Authors:
Heike A Bischoff-Ferrari; Walter C Willett; Endel J Orav; Endel J Oray; Paul Lips; Pierre J Meunier; Ronan A Lyons; Leon Flicker; John Wark; Rebecca D Jackson; Jane A Cauley; Haakon E Meyer; Michael Pfeifer; Kerrie M Sanders; Hannes B Stähelin; Robert Theiler; Bess Dawson-Hughes
Related Documents :
6735717 - Post-traumatic valgus deformity of the knee in proximal tibial metaphyseal fractures in...
22773017 - Aptf: antero-posterior tibio-fibular ratio a new reliable measure to assess syndesmotic...
18175127 - A simple technique for the correction of frontal bossing in synostotic scaphocephaly.
16218747 - Nanoscale deformation mechanisms in bone.
23469317 - Diagnosis of depression in adolescents following traumatic fracture: a retrospective an...
20843767 - Osteocalcin and specific markers of bone resorption in sickle cell disease.
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  367     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-05     Completed Date:  2012-07-11     Revised Date:  2012-10-05    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-9     Citation Subset:  AIM; IM    
Affiliation:
Center on Aging and Mobility, University of Zurich and Waid City Hospital, Zurich, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Calcium / therapeutic use
Calcium, Dietary / administration & dosage
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Fractures, Bone / prevention & control*
Hip Fractures / prevention & control*
Humans
Intention to Treat Analysis
Male
Randomized Controlled Trials as Topic
Risk
Vitamin D / administration & dosage*,  analogs & derivatives*,  blood
Chemical
Reg. No./Substance:
0/Calcium, Dietary; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D; 7440-70-2/Calcium
Comments/Corrections
Comment In:
N Engl J Med. 2012 Oct 4;367(14):1367-8; author reply 1369-70   [PMID:  23034036 ]
N Engl J Med. 2012 Oct 4;367(14):1367; author reply 1369-70   [PMID:  23034035 ]
N Engl J Med. 2012 Jul 5;367(1):77-8   [PMID:  22762324 ]
N Engl J Med. 2012 Oct 4;367(14):1368; author reply 1369-70   [PMID:  23034037 ]
Erratum In:
N Engl J Med. 2012 Aug 2;367(5):481
Note: Oray, Endel J [corrected to Orav, Endel J]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Cognitive trajectories after postoperative delirium.
Next Document:  Optimal stomatal conductance in relation to photosynthesis in climatically contrasting Eucalyptus sp...