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Prevention of nonvertebral fractures with oral vitamin D

A doos-response relationship between vitamin D and fracture reduction is supported by epidemiologic data showing a significant positive trend between serum 25-hydroxvitamin D concentrations and hip bone density and lower extremity strength.

To assess the amtifracture efficacy of oral vitamin D supplementation in the elderly, a recent study performed a meta-analysis on the efficacy of oral supplemental vitamin D in preventing nonvertebral and hip fractures among older individuals (> or = 65 years). This study included 12 double-blind randomized controlled trials (RCTs) for nonvertebral fractures (n = 42279) and 8 RCTs for hip fractures (n = 40886) comparing oral vitamin D with or without calcium, with calcium, or placebo.

The meta-analysis found that antifracture efficacy increased significantly with a higher dose and higher achieved blood 25-hydroxyvitamin D levels for prevention of both non-vertebral fractures and hip fractures.  The higher dose (>400IU) reduced nonvertebral fractures in community-dwelling individuals (-29%) and institutionalized older individuals (-15%), and its effect was independent of additional calcium supplementation.

CONCLUSION: Nonvertebral fracture prevention with vitamin D is dose dependent, and a higher dose should reduce fractures by at least 20% for individuals aged 65 years or older.

Source: Arch Intern Med. 2009 Mar 23;169(6):551-61

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