Financiado en parte por DSM Nutritional Products
A pooled analysis of vitamin D dose requirements for fracture prevention
Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes B
The New England journal of medicine · 500 citas
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiado por la industria
- Gobierno
- European Commission
- Universidad u hospital
- Universität Zürich
- Empresa
- DSM Nutritional Products
- Gobierno
- European Commission FP7
- Subvenciones
- European Commission (278588)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2012-07-05 · N Engl J Med · vol. 367 · número 1 · págs. 40–49
- Editorial
- Massachusetts Medical Society
- Citado
- 808 citas · más que el 100% de estudios similares · 72.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 28 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Bone health and osteoporosis research · Nutrition and Health Studies
- Palabras clave
- vitamin D supplementation, fracture prevention, hip fracture, non-vertebral fractures, older adults, calcium supplementation, 25-hydroxyvitamin D, osteoporosis, pooled analysis of trials, medication adherence, baseline vitamin D status, sex differences, age differences, subgroup analysis, fracture risk reduction
- MeSH
- humans, hip fractures, calcium, dietary, calcium, vitamin d, drug therapy, combination, risk, dose-response relationship, drug, aged, aged, 80 and over, female, male, fractures, bone, randomized controlled trials as topic, intention to treat analysis
16 autores
- Heike Annette Bischoff-Ferrari🇨🇭University of Zurich; University Hospital Zurich; Stadtspital Waid
- Walter Churchill Willett🇺🇸Harvard University
- Endel John Orav🇺🇸Harvard University
- Paul T.A.M. Lips🇳🇱Amsterdam Public Health; Amsterdam UMC Location Vrije Universiteit Amsterdam
- Pierre Jean Meunier🇫🇷Lyon 1 Université
- Ronan Anthony Lyons🇬🇧Swansea University
- Leon A Flicker🇦🇺The University of Western Australia
- John Dennis Wark🇦🇺The Royal Melbourne Hospital
- Rebecca D. Jackson🇺🇸The Ohio State University
- Jane A. Cauley🇺🇸University of Pittsburgh
- Helmut E. Meyer🇳🇴Norwegian Institute of Public Health; University of Oslo
- Michael Pfeifer
- Kerrie M. Sanders🇦🇺Barwon Health
- Hannes Benedikt Stähelin🇨🇭University Hospital of Basel
- Robert Theiler🇨🇭Triemli Hospital
- Bess Dawson‐Hughes🇺🇸Tufts University; United States Department of Agriculture; Jean Mayer Human Nutrition Research Center on Aging
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction have been inconsistent.
Methods
We pooled participant-level data from 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, as compared with placebo or calcium alone in persons 65 years of age or older. Primary end points were the incidence of hip and any nonvertebral fractures according to Cox regression analyses, with adjustment for age group, sex, type of dwelling, and study. Our primary aim was to compare data from quartiles of actual intake of vitamin D (including each individual participant's adherence to the treatment and supplement use outside the study protocol) in the treatment groups of all trials with data from the control groups.
Results
We included 31,022 persons (mean age, 76 years; 91% women) with 1111 incident hip fractures and 3770 nonvertebral fractures. Participants who were randomly assigned to receive vitamin D, as compared with those assigned to control groups, had a nonsignificant 10% reduction in the risk of hip fracture (hazard ratio, 0.90; 95% confidence interval [CI], 0.80 to 1.01) and a 7% reduction in the risk of nonvertebral fracture (hazard ratio, 0.93; 95% CI, 0.87 to 0.99). By quartiles of actual intake, reduction in the risk of fracture was shown only at the highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30% reduction in the risk of hip fracture (hazard ratio, 0.70; 95% CI, 0.58 to 0.86) and a 14% reduction in the risk of any nonvertebral fracture (hazard ratio, 0.86; 95% CI, 0.76 to 0.96). Benefits at the highest level of vitamin D intake were fairly consistent across subgroups defined by age group, type of dwelling, baseline 25-hydroxyvitamin D level, and additional calcium intake.
Conclusions
High-dose vitamin D supplementation (≥800 IU daily) was somewhat favorable in the prevention of hip fracture and any nonvertebral fracture in persons 65 years of age or older. (Funded by the Swiss National Foundations and others.).
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