Medium doses of daily vitamin D decrease falls and higher doses of daily vitamin D3 increase falls: A randomized clinical trial
Smith LM, Gallagher JC, Suiter C
The Journal of steroid biochemistry and molecular biology · 110 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute on Aging
- Gobierno
- National Institute of General Medical Sciences
- Gobierno
- NIGMS NIH HHS
- Gobierno
- NIA NIH HHS
- Subvenciones
- National Institute of General Medical Sciences (U54GM115458); National Institute on Aging (R01 AG028168)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2017-03-18 · J Steroid Biochem Mol Biol · vol. 173 · págs. 317–322
- Editorial
- Elsevier BV
- Citado
- 152 citas · más que el 99% de estudios similares · 13.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 28 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Vitamin D Research Studies · Balance, Gait, and Falls Prevention · Bone health and osteoporosis research
- Palabras clave
- vitamin D supplementation, vitamin D3, falls, fall prevention, older women, serum 25-hydroxyvitamin D, dose-response relationship, U-shaped curve, vitamin D deficiency, vitamin D toxicity, fall history, population aging
- MeSH
- humans, vitamin d deficiency, cholecalciferol, vitamins, vitamin d, double-blind method, accidental falls, dietary supplements, aged, middle aged, female
3 autores
- Lynette M. Smith🇺🇸Nebraska Medical Center; University of Nebraska Medical Center
- John Christopher Gallagher🇺🇸 · autor de correspondenciaCreighton University; CHI Health Creighton University Medical Center - Bergan Mercy
- C Suiter🇺🇸Creighton University; CHI Health Creighton University Medical Center - Bergan Mercy
Resumen
El texto original del estudio, en el idioma en que se publicó.
Falls are a serious health problem in the aging population. Because low levels of vitamin D have been associated with increased fall rates, many trials have been performed with vitamin D; two meta-analyses showed either a small effect or no effect of vitamin D on falls. We conducted a study of the effect of vitamin D on serum 25 hydroxyvitamin D (25OHD) and data on falls was collected as a secondary outcome. In a 12-month double blind randomized placebo trial, elderly women, mean age 66 years, were randomized to one of seven daily oral doses of vitamin D or placebo. The main inclusion criterion for study was a baseline serum 25OHD<20ng/ml (50nmol/L). A history of falls was collected at baseline and fall events were collected every 3 months. Results showed that the effect of vitamin D on falls followed a U-shaped curve whether analyzed by dose or serum 25OHD levels. There was no decrease in falls on low vitamin D doses 400, 800 IU, a significant decrease on medium doses 1600, 2400,3200 IU (p=0.020) and no decrease on high doses 4000, 4800 IU compared to placebo (p=0.55). When compared to 12-month serum 25OHD quintiles, the faller rate was 60% in the lowest quintile <25ng/ml (<50nmol/L), 21% in the low middle quintile 32-38ng/ml (80-95nmo/L), 72% in the high middle quintile 38-46ng/ml (95-115nmo/L) and 45% in the highest quintile 46-66ng/ml (115-165nmol/L). In the subgroup with a fall history, fall rates were 68% on low dose, 27% on medium doses and 100% on higher doses. Fall rates on high doses were increased compared to medium doses (Odds Ratio 5.6.95% CI: 2.1-14.8). In summary, the maximum decrease in falls corresponds to a 12- month serum 25OHD of 32-38ng/ml (80-95nmol/L) and faller rates increase as serum 25OHD exceed 40-45ng/ml (100-112.5nmol/L). The Tolerable upper limit (TUL) recently increased in 2010 from 2000 to 4000 IU/day may need to be reduced in elderly women especially in those with a fall history.
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