Michael Denman, MD, FRCP
In patients ≥ 65 years of age, does oral vitamin D prevent nonvertebral and hip fractures?
Included studies evaluated oral vitamin D supplementation and reported ≥ 1 fracture in patients with mean age ≥ 65 years; studies had to be double-blind and have ≥ 1 year of follow-up. Exclusion criteria included uncontrolled, observational, or animal studies; and studies of patients with organ transplantation or stroke, and those taking steroids or treatment for Parkinson disease. Outcomes were first or repeated nonvertebral fracture or hip fracture.
MEDLINE and Cochrane Controlled Trials Register (1960 to Aug 2008), EMBASE/Excerpta Medica (1991 to Aug 2008), reference lists, and abstracts from the American Society of Bone and Mineral Research (1995 to 2007) were searched, and experts were contacted for randomized controlled trials (RCTs). 12 high-quality RCTs (n = 42 279, mean age 78 y, 89% women) met the selection criteria.
Meta-analysis showed that vitamin D doses > 400 IU/d (range 482 to 770 IU/d) reduced nonvertebral and hip fractures but vitamin D doses ≤ 400 IU/d (range 340 to 380 IU/d) did not differ from placebo or calcium supplementation alone for nonvertebral or hip fractures (Table).
Oral vitamin D prevents nonvertebral and hip fractures in a dose-dependent manner in patients ≥ 65 years of age.
Different doses of vitamin D vs placebo or calcium supplementation alone in patients ≥ 65 years of age*
*NS = not significant; other abbreviations defined in Glossary. Weighted event rates, RRR, RRI, and CI fcalculated rom data in article based on a random-effects model. NNT and CI provided in article.
Michael Denman. Review: Oral vitamin D prevents nonvertebral and hip fractures in a dose-dependent manner in patients ≥ 65 years of age. Ann Intern Med. 2009;151:JC2–8. doi: 10.7326/0003-4819-151-4-200908180-02008
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Published: Ann Intern Med. 2009;151(4):JC2-8.
Geriatric Medicine, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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