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Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
October 1, 2013
Helen M Macdonald et al. (10 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

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.

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
AgedBiomarkersBone DensityBone ResorptionCholecalciferolDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleFibroblast Growth Factor-23HipHumansMiddle AgedParathyroid HormonePostmenopauseVitamin DWithholding Treatment
Study Links
Quality Scores
Safety85
Efficacy75/10
Quality90/10
Citation Metrics
Total Citations48
Citations/Year4.0
Relative Citation Ratio1.86
NIH Percentile72.4%
Research Impact Scores
APT Score0.75
Weight Score1.75
Normalized Score0.82
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