25-Hydroxyvitamin D Threshold for the Effects of Vitamin D Supplements on Bone Density: Secondary Analysis of a Randomized Controlled Trial
Macdonald HM, Reid IR, Gamble GD, Fraser WD, Tang JC, Wood AD
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 85 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute for Health and Care Research
- Organización sin fines de lucro
- National Osteoporosis Society
- Gobierno
- Health Research Council of New Zealand
- Gobierno
- National Institute for Health Research (NIHR)
- Gobierno
- Medical Research Council
- Subvenciones
- Health Research Council of New Zealand (15-576)
Según 5 financiadores declarados.
Publicación
- Publicado
- 2018-04-17 · J Bone Miner Res · vol. 33 · número 8 · págs. 1464–1469
- Editorial
- Oxford University Press
- Citado
- 122 citas · más que el 99% de estudios similares · 10.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 20 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Bone health and osteoporosis research · Pharmacological Effects and Toxicity Studies
- Palabras clave
- Medicine, Vitamin D and neurology, Bone mineral, Placebo, Osteomalacia, Parathyroid hormone, Internal medicine, Osteoporosis, Randomized controlled trial, Bone density, Endocrinology, vitamin D deficiency, Bone remodeling, Vitamin, Calcium
- MeSH
- hip, spine, humans, parathyroid hormone, vitamin d, bone density, dietary supplements, aged, middle aged, female
6 autores
- Helen M. Macdonald🇬🇧University of Aberdeen
- Ian R. Reid🇳🇿 · autor de correspondenciaUniversity of Auckland; Auckland District Health Board
- Gregory D. Gamble🇳🇿University of Auckland
- William Duncan Fraser🇬🇧University of East Anglia
- JONATHAN C. Y. TANG🇬🇧University of East Anglia
- Adrian D. Wood🇬🇧University of Aberdeen
Resumen
El texto original del estudio, en el idioma en que se publicó.
Most trials of vitamin D supplementation have shown no benefits on bone mineral density (BMD), although severe vitamin D deficiency causes osteomalacia, which is associated with profound BMD deficits. Recently, the ViDA-BMD study from New Zealand demonstrated a threshold of baseline 25-hydroxyvitamin D (25OHD; 30 nmol/L) below which vitamin D supplementation did benefit BMD. We have now reexamined data from a similar trial in Aberdeen to determine whether a baseline 25OHD threshold of 30 nmol/L is also observed in that database. The Aberdeen study recruited 305 postmenopausal women in late winter and randomized them to receive placebo, vitamin D 400 IU/d, or vitamin D 1000 IU/d over 1 year. As previously reported, BMD loss at the hip was reduced by vitamin D 1000 IU/d only, and there was no significant treatment effect of either dose at the lumbar spine. In the present analysis, when the trial participants were grouped according to whether their baseline 25OHD was ≤30 nmol/L or above this threshold, significant treatment effects were apparent at both the spine and hip in those with baseline 25OHD ≤30 nmol/L, but no significant effects were apparent in those with baseline 25OHD above this level. There was evidence of a similar threshold for effects on parathyroid hormone, but no groups showed changes in bone turnover markers during the study. It is concluded that vitamin D supplements only increase bone density in adults with nadir 25OHD ≤30 nmol/L. This moves us further toward a trial-based definition of vitamin D deficiency in adults with adequate calcium intakes and suggests that supplement use should be targeted accordingly. Future trials of vitamin D supplementation should focus on individuals with 25OHD concentrations in this range. © 2018 American Society for Bone and Mineral Research.
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