Dose of Vitamin D May Be Important In Fracture Prevention

In a recently published paper in march issue Archives of Internal Medicine, prevention of nonvertebral fractures with vitamin D is dose-dependent for individuals aged 65 years or older. The paper is based on meta-analysis of of randomized controlled trials.

Researchers found a significant positive trend between serum 25-hydroxyvitamin D concentrations and hip bone density and lower extremity strength. The reviewers identified 12 double-blind RCTs for nonvertebral fractures, enrolling a total of 42,279 subjects, and 8 RCTs for hip fractures, enrolling a total of 40,886 subjects, which compared the effects of oral vitamin D, with or without calcium, with those of calcium alone or of placebo.

The higher dose was associated with a 29% decrease in nonvertebral fractures in community dwelling individual. However in institutionalized individuals only 15% decrease was seen.

A higher received dose of supplemental vitamin D (482-770 IU/d) should reduce nonvertebral fractures by at least 20% and hip fractures by at least 18%,” the study authors write.

It is suggested that higher doses of vitamin D should be explored in future research to optimize antifracture efficacy. The greater benefits may be achieved with earlier initiation of vitamin D supplementation and longer duration of use.

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