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A pooled analysis of vitamin D dose requirements for fracture prevention
Bischoff-Ferrari, Heike Willett, Walter Orav, Endel J. Lips, Paul Meunier, Pierre J. Lyons, Ronan A. Flicker, Leon Wark, John Jackson, Rebecca D. Cauley, Jane A.
Bischoff-Ferrari, Heike
Willett, Walter
Orav, Endel J.
Lips, Paul
Meunier, Pierre J.
Lyons, Ronan A.
Flicker, Leon
Wark, John
Jackson, Rebecca D.
Cauley, Jane A.
Abstract
Approximately 75% of fractures occur in people 65 years of age or older.1 By 2050, the worldwide incidence of hip fractures is expected to increase by 240% among women and 310% among men.2 One strategy to prevent fractures in this population might be universal vitamin D supplementation. However, the results of several study level meta-analyses and one pooled participant-level analysis do not agree. Although one trial-level meta-analysis of double-blind, randomized, controlled trials suggested an 18% reduction in the incidence of hip fracture and a 20% reduction in the incidence of any nonvertebral fracture at a received dose of no less than 482 IU of vitamin D per day,3 three study-level meta-analyses4-6 and one pooled analysis of participant-level data7 from open-design and blinded trials suggested that vitamin D may have no effect on total fractures4 or may reduce hip fracture by 7 to 16%, if combined with calcium supplementation, regardless of the dose of vitamin D.4-7 The discordant findings may be explained, in part, by differences in the criteria for including trials in the analyses, with respect to blinding, vitamin D formulation (oral vs. injectable), or accommodations for nonadherence. Our analysis was designed to estimate the effects of vitamin D supplementation according to the actual intake of each participant, rather than simply the dose to which the participant was randomly assigned.
Keywords
Date
2012
Type
Journal article
Journal
New England Journal of Medicine
Book
Volume
367
Issue
1
Page Range
40-49
Article Number
ACU Department
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Event URL
Open Access Status
License
File Access
Controlled