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Supplementation of vitamin D isolated or calcium-associated with bone remodeling and fracture risk in postmenopausal women without osteoporosis: A systematic review of randomized clinical trials.

Nutrition (Burbank, Los Angeles County, Calif.)
December 1, 2023
Aline Rocha Reis et al. (8 authors)
Systematic ReviewJournal ArticleReviewResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to determine the effect of vitamin D supplementation, alone or combined with calcium, on bone remodeling and fracture risk in postmenopausal women without osteoporosis.

Results Summary

Vitamin D supplementation improved 25-hydroxyvitamin D levels and bone remodeling markers, but only one study showed reduced fracture risk (800 IU vitamin D plus 1200 mg calcium). Higher doses (4000 IU or 500,000 IU annually) did not consistently improve outcomes.

Population

Postmenopausal women without osteoporosis.

Effective Dosage

400 IU, 800-1000 IU, 4000 IU, 15,000 IU/week, 500,000 IU annually (vitamin D); 1200 mg (calcium).

Duration

Varied (6 months to 5 years).

Interactions

None mentioned.

Extracted Claims (11)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Vitamin D supplementation
increase
25-hydroxyvitamin D levels
women in postmenopause without osteoporosis
≥10 ng/mL
increased
#1
Vitamin D supplementation
decrease
parathyroid hormone secretion
women in postmenopause without osteoporosis
dependent on baseline levels
decreased
#2
400 IU of vitamin D
increase
percentage of carboxylated osteocalcin
women in postmenopause without osteoporosis
-
improved
#3
800 to 1000 IU of vitamin D combined with calcium
increase
bone mineral density
women in postmenopause without osteoporosis
-
resulted in reduced, improved, or maintained
#4
800 to 1000 IU of vitamin D combined with calcium
decrease
alkaline phosphatase levels
women in postmenopause without osteoporosis
-
reduced
#5
4000 IU of vitamin D alone or combined with calcium for 6 mo
no change
C-telopeptide and procollagen type 1 peptide levels
women in postmenopause without osteoporosis
-
did not improve
#6
15 000 IU/wk of vitamin D
increase
cortical area of metacarpal bone
women in postmenopause without osteoporosis
-
increased
#7
500 000 IU of vitamin D annually for 5 y
no change
fracture risk and falls
women in postmenopause without osteoporosis
-
did not contribute to reducing
#8
800 IU of vitamin D plus 1200 mg of calcium
decrease
fracture risk
women in postmenopause without osteoporosis
-
reduction in
#9
vitamin D supplementation, alone or calcium-associated
increase
status of 25-hydroxyvitamin D and bone remodeling
postmenopausal women
-
improved
#10
vitamin D supplementation, alone or calcium-associated
no change
fracture bone risk
postmenopausal women
-
it was not possible to assert that it reduced
#11
Abstract

Menopause and vitamin D deficiency increase bone reabsorption and bone fracture risk in women in postmenopause, and vitamin D supplementation may improve bone health and decrease bone fracture risk. This study aims to discuss the effect of vitamin D supplementation, isolated or calcium-associated, on remodeling and fracture risk bone in women in postmenopause without osteoporosis. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO database registration: CRD42022359796). A search was conducted in four databases and gray literature using MeSH and similar terms related to supplements, vitamin D, calcium, remodeling, and fracture bone, without the restriction of language and year of publication. A total of 3460 studies were identified, and nine were selected. Vitamin D supplementation increased 25-hydroxyvitamin D levels ≥10 ng/mL and decreased parathyroid hormone secretion dependent on baseline levels. The doses of 400 IU of vitamin D improved the percentage of carboxylated osteocalcin, whereas 800 to 1000 IU combined with calcium resulted in reduced, improved, or maintained bone mineral density and reduced alkaline phosphatase levels. However, 4000 IU alone or combined with calcium for 6 mo did not improve C-telopeptide and procollagen type 1 peptide levels. Additionally, 15 000 IU/wk increased the cortical area of metacarpal bone, whereas 500 000 IU of vitamin D annually for 5 y did not contribute to reducing the fracture risk and falls. Only one study found a reduction in fracture risk (dose of 800 IU of vitamin D plus 1200 mg of calcium). Thus, the vitamin D supplementation, alone or calcium-associated, improved the status of 25-hydroxyvitamin D and bone remodeling, but it was not possible to assert that it reduced fracture bone risk in postmenopausal women.

Medical Subject Headings (MeSH)
HumansFemaleCalciumPostmenopauseRandomized Controlled Trials as TopicVitamin DVitaminsOsteoporosisFractures, BoneCalcium, DietaryCalcifediolDietary SupplementsBone Remodeling
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations6
Citations/Year3.0
Relative Citation Ratio1.77
NIH Percentile70.6%
Research Impact Scores
APT Score0.50
Weight Score2.72
Normalized Score0.62
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