Need for Additional Calcium to Reduce the Risk of Hip Fracture with Vitamin D Supplementation: Evidence from a Comparative Metaanalysis of Randomized Controlled Trials
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Discussion
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Implication
Meta-analysis reveals reduced hip fracture risk in older adults receiving vitamin D combined with calcium but not vitamin D alone, indicating calcium is necessary for fracture prevention.
Key Points
- To determine whether additional calcium supplementation is required alongside oral vitamin D to achieve a significant reduction in hip fracture risk among older individuals.
- Systematic search of MEDLINE and EMBASE for randomized controlled trials evaluating oral vitamin D with or without calcium versus placebo or no treatment in postmenopausal women and older men (≥50 years).
- Conducted random-effects meta-analyses and an adjusted indirect comparison of pooled relative risks between regimens.
- Vitamin D alone across four RCTs (n=9,083) did not reduce hip fracture risk (pooled RR 1.10; 95% CI, 0.89–1.36) with no observed heterogeneity.
- Vitamin D co-supplemented with calcium across six RCTs (n=45,509) significantly reduced hip fracture risk (pooled RR 0.82; 95% CI, 0.71–0.94) with no heterogeneity.
- Adjusted indirect comparison demonstrated that vitamin D plus calcium significantly reduced hip fracture risk compared to vitamin D alone (RR 0.75; 95% CI, 0.58–0.96).
Cite This Study
Boonen et al. (2007) studied this question.