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« on: April 05, 2008, 06:27:49 pm » |
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NEW YORK (Reuters Health) May 18 - The risk of hip fracture appears to be reduced with oral vitamin D supplementation only when it is accompanied by additional calcium, according to a report in the April issue of The Journal of Clinical Endocrinology & Metabolism.
"Supplementation should be targeted to individuals with insufficiencies," Dr. Steven Boonen from Katholieke Universiteit Leuven, Belgium told Reuters Health. "And that is why supplementation should focus on individuals with documented calcium (<1200 mg/d) and vitamin D (<50 nmol/L) insufficiency, individuals most likely to be calcium and vitamin D insufficient (subjects older than 75, home bound, or institutionalized), and patients with documented osteoporosis on anabolic or antiresorptive therapy."
Dr. Boonen and associates performed an adjusted indirect comparison of two pooled-risk estimates for hip fracture: one from a meta-analysis of vitamin D trials and one from a meta-analysis of vitamin D plus calcium trials, both compared with placebo or no treatment.
The pooled relative risk for hip fracture from the vitamin D only trials was a statistically nonsignificant 1.10, the authors report. In contrast, the pooled relative risk from vitamin D plus calcium trials was a statistically significant 0.82, the report indicates.
Comparing the two meta-analyses gave a significant adjusted relative risk of 0.75 in favor of vitamin D with additional calcium, the investigators say, "suggesting that the combination reduces the risk of hip fracture by 25% compared with vitamin D alone."
"A negative calcium balance is driving bone loss with aging, and in most individuals this negative calcium balance is due to the combination of inadequate calcium intake and suboptimal vitamin D status," Dr. Boonen said. "That is why, in most individuals, a combination of calcium and vitamin D is required to restore calcium balance and reduce fracture risk."
"Current evidence indicates that you need at least 800 IU of vitamin D to reduce fracture risk (and that you need additional calcium supplements), but what we don't know is whether 800 IU of vitamin D is the optimal dose for musculoskeletal health," Dr. Boonen added. "Future research should focus on this question."
J Clin Endocrinol Metab 2007;92:1415-1423.
Source: http://www.medscape.com/viewarticle/556725?src=mp
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