| A pooled analysis of vitamin D dose requirements for fracture prevention. | |
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MedLine Citation:
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PMID: 22762317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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.). |
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Authors:
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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 |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The New England journal of medicine Volume: 367 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-07-05 Completed Date: 2012-07-11 Revised Date: 2012-10-05 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
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Languages: eng Pagination: 40-9 Citation Subset: AIM; IM |
Affiliation:
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Center on Aging and Mobility, University of Zurich and Waid City Hospital, Zurich, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Calcium, Dietary; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D; 7440-70-2/Calcium |
| Comments/Corrections | |
Comment In:
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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:
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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
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