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Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
January 1, 2016
C M Weaver et al. (10 authors)
Journal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to determine whether calcium plus vitamin D supplementation reduces fracture risk in adults through a meta-analysis of randomized controlled trials.

Results Summary

The meta-analysis found a statistically significant 15% reduction in total fractures and a 30% reduction in hip fractures with calcium plus vitamin D supplementation. Sensitivity and subgroup analyses supported these findings.

Population

Community-dwelling and institutionalized middle-aged to older adults (30,970 participants across eight studies).

Effective Dosage

Not specified in the abstract.

Duration

Not specified in the abstract.

Interactions

None mentioned.

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
calcium plus vitamin D supplementation
decrease
total fractures
adults
15 %
significant 15 % reduced risk
#1
calcium plus vitamin D supplementation
decrease
hip fractures
adults
30 %
30 % reduced risk
#2
calcium plus vitamin D supplementation
decrease
total fractures
-
15 %
produced a statistically significant 15 % reduced risk
#3
calcium plus vitamin D supplementation
decrease
hip fractures
-
30 %
30 % reduced risk
#4
calcium plus vitamin D supplements
decrease
fracture risk
both community-dwelling and institutionalized middle-aged to older adults
-
supports the use ... as an intervention for fracture risk reduction
#5
Abstract

UNLABELLED: The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). INTRODUCTION: Calcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults. METHODS: A PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran's Q test and the I (2) statistic, and potential for publication bias was assessed. RESULTS: Of the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women's Health Initiative. CONCLUSIONS: This meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.

Medical Subject Headings (MeSH)
Bone Density Conservation AgentsCalciumDietary SupplementsDrug Therapy, CombinationHumansOsteoporosis, PostmenopausalOsteoporotic FracturesRandomized Controlled Trials as TopicRisk AssessmentVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations362
Citations/Year40.2
Relative Citation Ratio18.11
NIH Percentile99.3%
Research Impact Scores
APT Score0.95
Weight Score2.44
Normalized Score0.72
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