Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis
Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A
Lancet (London, England) · 785 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Australian Government
Según 1 financiador declarado.
Publicación
- Publicado
- 2007-08-01 · Lancet · vol. 370 · número 9588 · págs. 657–666
- Editorial
- Elsevier BV
- Citado
- 1,246 citas · más que el 100% de estudios similares · 13.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 55 trabajos
- Acceso
- De pago
- Áreas de investigación
- Bone health and osteoporosis research · Vitamin D Research Studies · Nutrition and Health Studies
- Palabras clave
- calcium supplementation, vitamin D supplementation, osteoporosis prevention, osteoporotic fractures, bone mineral density, bone loss, older adults, medication adherence, vitamin D dose
- MeSH
- humans, osteoporosis, fractures, spontaneous, calcium, vitamin d, drug therapy, combination, risk, regression analysis, patient compliance, bone density, dose-response relationship, drug, aged, aged, 80 and over, middle aged, female, male
5 autores
- Benjamin M. P. Tang🇦🇺 · autor de correspondenciaThe University of Sydney; Nepean Hospital; Western Sydney University
- Guy D. Eslick🇦🇺The University of Sydney; Nepean Hospital
- Caryl Anne Nowson🇦🇺Deakin University
- Caroline Anne Smith🇦🇺Western Sydney University
- Alan Bensoussan🇦🇺Western Sydney University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Whether calcium supplementation can reduce osteoporotic fractures is uncertain. We did a meta-analysis to include all the randomised trials in which calcium, or calcium in combination with vitamin D, was used to prevent fracture and osteoporotic bone loss.
Methods
We identified 29 randomised trials (n=63 897) using electronic databases, supplemented by a hand-search of reference lists, review articles, and conference abstracts. All randomised trials that recruited people aged 50 years or older were eligible. The main outcomes were fractures of all types and percentage change of bone-mineral density from baseline. Data were pooled by use of a random-effect model.
Findings
In trials that reported fracture as an outcome (17 trials, n=52 625), treatment was associated with a 12% risk reduction in fractures of all types (risk ratio 0.88, 95% CI 0.83-0.95; p=0.0004). In trials that reported bone-mineral density as an outcome (23 trials, n=41 419), the treatment was associated with a reduced rate of bone loss of 0.54% (0.35-0.73; p<0.0001) at the hip and 1.19% (0.76-1.61%; p<0.0001) in the spine. The fracture risk reduction was significantly greater (24%) in trials in which the compliance rate was high (p<0.0001). The treatment effect was better with calcium doses of 1200 mg or more than with doses less than 1200 mg (0.80 vs 0.94; p=0.006), and with vitamin D doses of 800 IU or more than with doses less than 800 IU (0.84 vs 0.87; p=0.03).
Interpretation
Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, we recommend minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation).
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