John F. Aloia, MD; Ashok Vaswani, MD; James K. Yeh, PhD; Patrick L. Ross, PhD; Edith Flaster, MS; F. Avraham Dilmanian, PhD
To determine whether augmentation of dietary calcium is effective in the prevention of early postmenopausal bone loss.
Three-arm, placebo-controlled, randomized parallel trial. The study duration was 2.9 ±1.1 (SD) years.
118 healthy, white women 3 to 6 years after spontaneous menopause, recruited by community announcement.
Random allocation to daily intake of 1700 mg of calcium (calcium carbonate given in divided doses with meals); placebo; or conjugated equine estrogens (0.625 mg; days 1 to 25), progesterone (10 mg; days 16 to 25), and 1700 mg of elemental calcium daily. Each participant received 400 IU of vitamin D daily.
Total body calcium measured by delayed γ neutron activation analysis and whole-body counting; bone mineral density of the spine, femur, and radius measured by photon absorptiometry.
Bone mineral density declined in the placebo group for the lumbar spine ( −2.1%/y;95% CI, −3.3 to −0.9),femoral neck ( −2.0%/y;CI,-2.6 to −1.2),trochanter ( −1.6%/y;CI, −2.4 to −0.8),Ward triangle ( −2.7%/y;CI, −3.7 to −1.7),and total body calcium ( −2.0%/y;CI, −2.2 to −1.8).Rates of change were intermediate for calcium augmentation compared with placebo and estrogen-progesterone-calcium but statistically significant compared with placebo for total body calcium ( −0.5%/y;CI, −0.9 to −0.1; P = 0.006) and the femoral neck ( −0.8%/y;CI, −1.4 to −0.2; P = 0.03).
Although less effective than estrogen-progesterone-calcium, calcium augmentation alone significantly retards bone loss from the femoral neck and improves calcium balance in recently postmenopausal women. Dietary calcium augmentation should be recommended as a strategic option in helping to prevent early postmenopausal bone loss.
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Aloia JF, Vaswani A, Yeh JK, Ross PL, Flaster E, Dilmanian FA. Calcium Supplementation with and without Hormone Replacement Therapy To Prevent Postmenopausal Bone Loss. Ann Intern Med. 1994;120:97–103. doi: 10.7326/0003-4819-120-2-199401150-00001
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Published: Ann Intern Med. 1994;120(2):97-103.
Endocrine and Metabolism, Metabolic Bone Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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