Meta-analyses of therapies for postmenopausal osteoporosis. VIII: Meta-analysis of the efficacy of vitamin D treatment in preventing osteoporosis in postmenopausal women
Papadimitropoulos E, Wells G, Shea B, Gillespie W, Weaver B, Zytaruk N, Cranney A, Adachi J, Tugwell P, Josse R, Greenwood C, Guyatt G, Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group
Endocrine reviews · 161 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2002-08-01 · Endocr Rev · vol. 23 · número 4 · págs. 560–569
- Editorial
- Oxford University Press
- Citado
- 302 citas · más que el 74% de estudios similares · 1.6× el promedio de su campo
- Referencias
- 54 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Bone health and osteoporosis research · Vitamin K Research Studies
- Palabras clave
- vitamin D, osteoporosis prevention, postmenopausal women, bone mineral density, vertebral fractures, non-vertebral fractures, calcium supplementation, fracture risk
- MeSH
- humans, osteoporosis, postmenopausal, vitamin d, female, randomized controlled trials as topic
12 autores
- Emmanuel Papadimitropoulos
- George Wells
- Beverley Shea
- William John Gillespie
- Bruce Weaver
- Nicole L. Zytaruk
- Ann Cranney
- Jonathan Derrick Adachi
- Peter Tugwell
- Robert G. Josse
- Carol E. Greenwood
- Gordon Henry Guyatt
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To review the effect of vitamin D on bone density and fractures in postmenopausal women.
Data source
We searched MEDLINE and EMBASE from 1966 to 1999 and examined citations of relevant articles and proceedings of international meetings. We contacted osteoporosis investigators and primary authors to identify additional studies and to obtain unpublished data.
Study selection
We included 25 trials that randomized women to standard or hydroxylated vitamin D with or without calcium supplementation or a control and measured bone density or fracture incidence for at least 1 yr.
Data extraction
For each trial, three independent reviewers assessed the methodological quality and abstracted data.
Data synthesis
Vitamin D reduced the incidence of vertebral fractures [relative risk (RR) 0.63, 95% confidence interval (CI) 0.45-0.88, P < 0.01) and showed a trend toward reduced incidence of nonvertebral fractures (RR 0.77, 95% CI 0.57-1.04, P = 0.09). Most patients in the trials that evaluated vertebral fractures received hydroxylated vitamin D, and most patients in the trials that evaluated nonvertebral fractures received standard vitamin D. Hydroxylated vitamin D had a consistently larger impact on bone density than did standard vitamin D. For instance, total body differences in percentage change between hydroxylated vitamin D and control were 2.06 (0.72, 3.40) and 0.40 (-0.25, 1.06) for standard vitamin D. At the lumbar spine and forearm sites, hydroxylated vitamin D doses above 50 microg yield larger effects than lower doses. Vitamin D resulted in an increased risk of discontinuing medication in comparison to control as a result of either symptomatic adverse effects or abnormal laboratory results (RR 1.37, 95% CI 1.01-1.88), an effect that was similar in trials of standard and hydroxylated vitamin D.
Conclusions
Vitamin D decreases vertebral fractures and may decrease nonvertebral fractures. The available data are uninformative regarding the relative effects of standard and hydroxylated vitamin D.
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