Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women.
Study Goal
The researchers aimed to determine whether daily oral vitamin D3 at 400 IU or 1000 IU compared with placebo affects annual bone mineral density (BMD) change in postmenopausal women.
Results Summary
The 1000 IU vitamin D group showed significantly less BMD loss at the hip compared to the 400 IU or placebo groups. Treatment did not significantly alter bone metabolism markers, except for a small reduction in PTH and an increase in serum calcium (with the 1000 IU dose only).
Population
White postmenopausal women aged 60 to 70 years in Scotland.
Effective Dosage
400 IU or 1000 IU vitamin D3 daily.
Duration
1 year.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
daily oral vitamin D3 at 1000 IU | decrease | mean BMD loss at the hip | postmenopausal women | 0.05% ± 1.46% (compared to 0.57% ± 1.33% for 400 IU and 0.60% ± 1.67% for placebo) | significantly less | #1 |
daily oral vitamin D3 at 400 IU | no change | mean BMD loss at the hip | postmenopausal women | 0.57% ± 1.33% (compared to 0.60% ± 1.67% for placebo) | no significant difference | #2 |
placebo | no change | mean BMD loss at the hip | postmenopausal women | 0.60% ± 1.67% | no significant difference | #3 |
placebo | decrease | 25(OH)D | postmenopausal women | -4.1 ± 11.5 nmol/L | changed | #4 |
daily oral vitamin D3 at 400 IU | increase | 25(OH)D | postmenopausal women | +31.6 ± 19.8 nmol/L | changed | #5 |
daily oral vitamin D3 at 1000 IU | increase | 25(OH)D | postmenopausal women | +42.6 ± 18.9 nmol/L | changed | #6 |
vitamin D treatment | no change | markers of bone metabolism | postmenopausal women | - | did not change | #7 |
vitamin D treatment | decrease | PTH | postmenopausal women | - | small reduction | #8 |
daily oral vitamin D3 at 1000 IU | increase | serum calcium | postmenopausal women | - | increase | #9 |
Few year-long vitamin D supplementation trials exist that match seasonal changes. The aim of this study was to determine whether daily oral vitamin D3 at 400 IU or 1000 IU compared with placebo affects annual bone mineral density (BMD) change in postmenopausal women in a 1-year double-blind placebo controlled trial in Scotland. White women aged 60 to 70 years (n = 305) were randomized to one of two doses of vitamin D or placebo. All participants started simultaneously in January/February 2009, attending visits at bimonthly intervals with 265 (87%) women attending the final visit and an additional visit 1 month after treatment cessation. BMD (Lunar iDXA) and 1,25-dihydroxyvitamin D[1,25(OH)2 D], N-terminal propeptide of type 1 collagen [P1NP], C-terminal telopeptide of type I collagen [CTX], and fibroblast growth factor-23 [FGF23] were measured by immunoassay at the start and end of treatment. Circulating PTH, serum Ca, and total 25-hydroxyvitamin D [25(OH)D] (latter by tandem mass spectrometry) were measured at each visit. Mean BMD loss at the hip was significantly less for the 1000 IU vitamin D group (0.05% ± 1.46%) compared with the 400 IU vitamin D or placebo groups (0.57% ± 1.33% and 0.60% ± 1.67%, respectively) (p < 0.05). Mean (± SD) baseline 25(OH)D was 33.8 ± 14.6 nmol/L; comparative 25(OH)D change for the placebo, 400 IU, and 1000 IU vitamin D groups was -4.1 ± 11.5 nmol/L, +31.6 ± 19.8 nmol/L, and +42.6 ± 18.9 nmol/L, respectively. Treatment did not change markers of bone metabolism, except for a small reduction in PTH and an increase in serum calcium (latter with 1000 IU dose only). The discordance between the incremental increase in 25(OH)D between the 400 IU and 1000 IU vitamin D and effect on BMD suggests that 25(OH)D may not accurately reflect clinical outcome, nor how much vitamin D is being stored.