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Vitamin D and fracture prevention


Bischoff-Ferrari, Heike A (2012). Vitamin D and fracture prevention. Rheumatic Disease Clinics of North America, 38(1):107-113.

Abstract

Based on evidence from double-blind RCTs, vitamin D supplementation reduces falls and nonvertebral fractures, including those at the hip. However, this benefit is dose-dependent. According to 2 meta-analysis in 2009 of double-blind RCTs, no fall reduction was observed for a dose of less than 700 IU per day. A higher dose of 700 to 1000 IU supplemental vitamin D per day reduced falls by 19%. Similarly, no fracture reduction was observed for a received dose of 400 IU or less per day. A higher received dose of 482 to 770 IU supplemental vitamin D per day reduced nonvertebral fractures by 20% and hip fractures by 18%. The antifracture effect was present in all subgroups of the older population and was most pronounced among community-dwellers (-29%) and those ages 65 to 74 years (-33%). Consistently, fall prevention and nonvertebral fracture prevention increased significantly with higher achieved 25-hydroxyvitamin D levels in the 2009 meta-analyses. Fall prevention occurred with 25-hydroxyvitamin D levels of 60 to 95 nmol/L; levels of 75 to 112 nmol/L were required for nonvertebral fracture prevention. Given the absence of data beyond this beneficial range, these recent meta-analyses do not preclude the possibility that higher doses or higher achieved 25-hydroxyvitamin D concentrations would have been even more efficient in reducing falls and nonvertebral fractures.

Abstract

Based on evidence from double-blind RCTs, vitamin D supplementation reduces falls and nonvertebral fractures, including those at the hip. However, this benefit is dose-dependent. According to 2 meta-analysis in 2009 of double-blind RCTs, no fall reduction was observed for a dose of less than 700 IU per day. A higher dose of 700 to 1000 IU supplemental vitamin D per day reduced falls by 19%. Similarly, no fracture reduction was observed for a received dose of 400 IU or less per day. A higher received dose of 482 to 770 IU supplemental vitamin D per day reduced nonvertebral fractures by 20% and hip fractures by 18%. The antifracture effect was present in all subgroups of the older population and was most pronounced among community-dwellers (-29%) and those ages 65 to 74 years (-33%). Consistently, fall prevention and nonvertebral fracture prevention increased significantly with higher achieved 25-hydroxyvitamin D levels in the 2009 meta-analyses. Fall prevention occurred with 25-hydroxyvitamin D levels of 60 to 95 nmol/L; levels of 75 to 112 nmol/L were required for nonvertebral fracture prevention. Given the absence of data beyond this beneficial range, these recent meta-analyses do not preclude the possibility that higher doses or higher achieved 25-hydroxyvitamin D concentrations would have been even more efficient in reducing falls and nonvertebral fractures.

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11 citations in Web of Science®
13 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:360 Social problems & social services
300 Social sciences, sociology & anthropology
Language:English
Date:2012
Deposited On:28 Feb 2013 09:38
Last Modified:05 Apr 2016 16:39
Publisher:Elsevier
ISSN:0889-857X
Publisher DOI:https://doi.org/10.1016/j.rdc.2012.03.010
PubMed ID:22525846

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