Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 16;9(10):e024595.
doi: 10.1136/bmjopen-2018-024595.

Comparison of Fracture Risk Using Different Supplemental Doses of Vitamin D, Calcium or Their Combination: A Network Meta-Analysis of Randomised Controlled Trials

Affiliations
Free PMC article

Comparison of Fracture Risk Using Different Supplemental Doses of Vitamin D, Calcium or Their Combination: A Network Meta-Analysis of Randomised Controlled Trials

Zhi-Chao Hu et al. BMJ Open. .
Free PMC article

Abstract

Objective: Inconsistent findings in regard to association between different concentrations of vitamin D, calcium or their combination and the risk of fracture have been reported during the past decade in community-dwelling older people. This study was designed to compare the fracture risk using different concentrations of vitamin D, calcium or their combination.

Design: A systematic review and network meta-analysis.

Data sources: Randomised controlled trials in PubMed, Cochrane library and Embase databases were systematically searched from the inception dates to 31 December 2017.

Outcomes: Total fracture was defined as the primary outcome. Secondary outcomes were hip fracture and vertebral fracture. Due to the consistency of the original studies, a consistency model was adopted.

Results: A total of 25 randomised controlled trials involving 43 510 participants fulfilled the inclusion criteria. There was no evidence that the risk of total fracture was reduced using different concentrations of vitamin D, calcium or their combination compared with placebo or no treatment. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of hip or vertebral fractures.

Conclusions: The use of supplements that included calcium, vitamin D or both was not found to be better than placebo or no treatment in terms of risk of fractures among community-dwelling older adults. It means the routine use of these supplements in community-dwelling older people should be treated more carefully.

Prospero registration number: CRD42017079624.

Keywords: calcium; fractures; network meta-analysis; vitamin D.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The selection of literature for included studies. RCT, randomised controlled trial.
Figure 2
Figure 2
(A) The network plot of comparisons on total fractures, (B) hip fractures and (C) vertebral fractures. A, high calcium (≥800 mg/day); B, low calcium (<800 mg/day); C, high vitamin D (≥800 IU/day); D, low vitamin D (<800 IU/day).
Figure 3
Figure 3
The forest plot for the risk of total fractures. A, high calcium (≥800 mg/day); B, low calcium (<800 mg/day); C, high vitamin D (≥800 IU/day); D, low vitamin D (<800 IU/day). CI, confidence interval; PrI, predictive interval.
Figure 4
Figure 4
The forest plot for the risk of hip fractures. A, high calcium (≥800 mg/day); B, low calcium (<800 mg/day); C, high vitamin D (≥800 IU/day); D, low vitamin D (<800 IU/day).
Figure 5
Figure 5
The forest plot for the risk of vertebral fractures. A, high calcium (≥800 mg/day); B, low calcium (<800 mg/day); C, high vitamin D (≥800 IU/day); D, low vitamin D (<800 IU/day).

Similar articles

See all similar articles

References

    1. Svedbom A, Hernlund E, Ivergård M, et al. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 2013;8:137 10.1007/s11657-013-0137-0 - DOI - PMC - PubMed
    1. Mohd-Tahir N-A, Li S-C. Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int 2017;28:2035–44. 10.1007/s00198-017-3985-4 - DOI - PubMed
    1. Kim J, Lee E, Kim S, et al. Economic burden of osteoporotic fracture of the elderly in South Korea: a national survey. Value Health Reg Issues 2016;9:36–41. 10.1016/j.vhri.2015.09.007 - DOI - PubMed
    1. Qu B, Ma Y, Yan M, et al. The economic burden of fracture patients with osteoporosis in Western China. Osteoporos Int 2014;25:1853–60. 10.1007/s00198-014-2699-0 - DOI - PubMed
    1. Wright NC, Looker AC, Saag KG, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 2014;29:2520–6. 10.1002/jbmr.2269 - DOI - PMC - PubMed

Publication types

LinkOut - more resources

Feedback