CONTEXT: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported. OBJECTIVE: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes. DESIGN, SETTING, AND PARTICIPANTS: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr. INTERVENTIONS: The interventions were 1200 mg/d calcium with placebo vitamin D (Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo (control). MAIN OUTCOME MEASURES: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured. RESULTS:Hip BMD was preserved in CaD (-0.17%) and Ca (0.19%) groups but not controls (-1.27%) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median (68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3% lower plasma alkaline phosphatase, respectively (P<or=0.02), and 28.7 and 34.5% lower urinary deoxypyridinoline to creatinine ratio, respectively (P<or=0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3%, P<or=0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads. CONCLUSIONS: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.
RCT Entities:
CONTEXT: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported. OBJECTIVE: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes. DESIGN, SETTING, AND PARTICIPANTS: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr. INTERVENTIONS: The interventions were 1200 mg/d calcium with placebo vitamin D (Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo (control). MAIN OUTCOME MEASURES: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured. RESULTS: Hip BMD was preserved in CaD (-0.17%) and Ca (0.19%) groups but not controls (-1.27%) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median (68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3% lower plasma alkaline phosphatase, respectively (P<or=0.02), and 28.7 and 34.5% lower urinary deoxypyridinoline to creatinine ratio, respectively (P<or=0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3%, P<or=0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads. CONCLUSIONS: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.
Authors: Paulette D Chandler; Lu Wang; Xi Zhang; Howard D Sesso; Manickavasagar V Moorthy; Obiageli Obi; Joshua Lewis; Richard L Prince; Jacqueline S Danik; JoAnn E Manson; Meryl S LeBoff; Yiqing Song Journal: Nutr Rev Date: 2015-07-14 Impact factor: 7.110
Authors: Joshua R Lewis; John T Schousboe; Wai H Lim; Germaine Wong; Kevin E Wilson; Kun Zhu; Peter L Thompson; Douglas P Kiel; Richard L Prince Journal: J Bone Miner Res Date: 2018-03-25 Impact factor: 6.741
Authors: Sue A Shapses; Deeptha Sukumar; Stephen H Schneider; Yvette Schlussel; Robert M Sherrell; M Paul Field; Hasina Ambia-Sobhan Journal: Am J Clin Nutr Date: 2013-01-30 Impact factor: 7.045