Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

Lai, Jeffrey K. C.; Lucas, Robyn M.; Clements, Mark S.; Roddam, Andrew W.; Banks, Emily
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p331
Academic Journal
journal article
Background: Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT) evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH) and hip fracture risk.Methods: We undertook separate meta-analyses of RCTs examining vitamin D supplementation and hip fracture, and observational studies of serum vitamin D status (25-hydroxyvitamin D (25(OH)D) level), PTH and hip fracture. Results from RCTs were combined using the reported hazard ratios/relative risks (RR). Results from case-control studies were combined using the ratio of 25(OH)D and PTH measurements of hip fracture cases compared with controls. Original published studies of vitamin D, PTH and hip fracture were identified through PubMed and Web of Science databases, searches of reference lists and forward citations of key papers.Results: The seven eligible RCTs identified showed no significant difference in hip fracture risk in those randomised to cholecalciferol or ergocalciferol supplementation versus placebo/control (RR = 1.13[95%CI 0.98-1.29]; 801 cases), with no significant difference between trials of <800 IU/day and > or = 800 IU/day. The 17 identified case-control studies found 33% lower serum 25(OH)D levels in cases compared to controls, based on 1903 cases. This difference was significantly greater in studies with population-based compared to hospital-based controls (chi(2)(1) (heterogeneity) = 51.02, p < 0.001) and significant heterogeneity was present overall (chi(2)(16) (heterogeneity) = 137.9, p < 0.001). Serum PTH levels in hip fracture cases did not differ significantly from controls, based on ten case-control studies with 905 cases (chi(2)(9) (heterogeneity) = 149.68, p < 0.001).Conclusions: Neither higher nor lower dose vitamin D supplementation prevented hip fracture. Randomised and observational data on vitamin D and hip fracture appear to differ. The reason for this is unclear; one possible explanation is uncontrolled confounding in observational studies. Post-fracture PTH levels are unrelated to hip fracture risk.


Related Articles

  • Recent developments in vitamin D deficiency and muscle weakness among elderly people. Venning, Geoff // BMJ: British Medical Journal (International Edition);3/5/2005, Vol. 330 Issue 7490, p524 

    Presents a review that discusses recent developments in screening and treating vitamin D deficiency among elderly housebound people aimed at reducing the incidence of falls and fractures. Association of vitamin D deficiency with muscle weakness as well as osteomalacia; Need for the...

  • Vitamin D Analogs Versus Native Vitamin D in Preventing Bone Loss and Osteoporosis-Related Fractures: A Comparative Meta-analysis. Richy, F.; Schacht, E.; Bruyere, O.; Ethgen, O.; Gourlay, M.; Reginster, J.-Y. // Calcified Tissue International;Mar2005, Vol. 76 Issue 3, p176 

    It has been suggested that early postmenopausal women and patients treated with steroids should receive preventive therapy (calcium, vitamin D, vitamin D analogs, estrogens, or bisphosphonates) to preserve their bone mineral density (BMD) and to avoid fragility fractures. We designed the present...

  • Mechanism and Potential of the Growth-Inhibitory Actions of Vitamin D and Analogs. Eelen, G.; Gysemans, C.; Verlinden, L.; Vanoirbeek, E.; De Clercq, P.; Van Haver, D.; Mathieu, C.; Bouillon, R.; Verstuyf, A. // Current Medicinal Chemistry;2007, Vol. 14 Issue 17, p1893 

    1a,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] can exert its biological actions through binding with the nuclear vitamin D receptor (VDR), a ligand-activated transcription factor. Next to control of bone and mineral homeostasis, these actions include an immunomodulatory effect and a potent...

  • If I had CIS with MRI diagnostic of MS, I would take vitamin D 10,000 IU daily: Commentary. Hutchinson, Michael // Multiple Sclerosis Journal;Feb2013, Vol. 19 Issue 2, p143 

    The author discusses the indirect sources of evidence to support the hypothesis that large doses of Vitamin C is a strong immune modulator and that Vitamin D deficiency is a major factor both in severity and susceptibility of multiple sclerosis (MS). He states the importance of the national MS...

  • Resolving Vitamin D Deficiency in the Preconception Period among High-Risk Reproductive Women: A Randomized Controlled Trial. Taheri, Mahshid; Baheiraei, Azam; Foroushani, Abbas Rahimi; Modarres, Maryam // Iranian Red Crescent Medical Journal;Jan2014, Vol. 16 Issue 1, p1 

    Background: Although vitamin D deficiency has been linked to potential complications in reproductive women, the recommended intake dosage of this vitamin in populations with high incidence of deficiency in preconception period has not been defined. Objectives: The study investigated the effect...

  • Review: prophylactic use of vitamin D reduces falls in older persons. Bischoff-Ferrari, H. A.; Dawson-Hughes, B.; Willett, W. C. // Evidence Based Medicine;Nov/Dec2004, Vol. 9 Issue 6, p169 

    The article reports that prophylactic use of vitamin D reduces falls in older persons. Falls are a serious concern in older persons because of their high prevalence and potential to lead to severe morbidity or mortality. The meta-analysis of 5 randomized controlled trials by researcher H.A....

  • vitamin D. EDELSTEIN, JULIA // Real Simple;Apr2013, Vol. 14 Issue 4, p50 

    The article presents questions and answers related to vitamin D such as, why so many people lack vitamin D, how much vitamin D one need, and vitamin D source from sun.

  • Vitamin D and you.  // Asian Pacific Post;6/30/2011, p5 

    The article offers tips on how to get the daily requirement for Vitamin D.

  • calcitriol.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p338 

    An encyclopedia entry for "calcitriol," which refers to the active hormone form of vitamin D that promotes the calcium and phosphate absorption in the intestines is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics