Journal article
Calcium plus vitamin D supplementation and the risk of fractures
The New England journal of medicine, Vol.354(7), pp.669-683
2006
DOI: 10.1056/NEJMoa055218
PMID: 16481635
Abstract
BACKGROUND: The efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy postmenopausal women remains equivocal. METHODS: We recruited 36,282 postmenopausal women, 50 to 79 years of age, who were already enrolled in a Women's Health Initiative (WHI) clinical trial. We randomly assigned participants to receive 1000 mg of elemental calcium as calcium carbonate with 400 IU of vitamin D3 daily or placebo. Fractures were ascertained for an average follow-up period of 7.0 years. Bone density was measured at three WHI centers. RESULTS: Hip bone density was 1.06 percent higher in the calcium plus vitamin D group than in the placebo group (P<0.01). Intention-to-treat analysis indicated that participants receiving calcium plus vitamin D supplementation had a hazard ratio of 0.88 for hip fracture (95 percent confidence interval, 0.72 to 1.08), 0.90 for clinical spine fracture (0.74 to 1.10), and 0.96 for total fractures (0.91 to 1.02). The risk of renal calculi increased with calcium plus vitamin D (hazard ratio, 1.17; 95 percent confidence interval, 1.02 to 1.34). Censoring data from women when they ceased to adhere to the study medication reduced the hazard ratio for hip fracture to 0.71 (95 percent confidence interval, 0.52 to 0.97). Effects did not vary significantly according to prerandomization serum vitamin D levels. CONCLUSIONS: Among healthy postmenopausal women, calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, did not significantly reduce hip fracture, and increased the risk of kidney stones. (ClinicalTrials.gov number, NCT00000611.) Copyright © 2006 Massachusetts Medical Society.
Details
- Title: Subtitle
- Calcium plus vitamin D supplementation and the risk of fractures
- Creators
- Rebecca D Jackson - The Ohio State UniversityAndrea Z Lacroix - Fred Hutch Cancer CenterDenise E Bonds - Wake Forest UniversityRobert L Brunner - The Ohio State UniversityRobert G Brzyski - The University of Texas at San AntonioBette Caan - Kaiser PermanenteJane A Cauley - University of PittsburghRowan T Chlebowski - University of California, Los AngelesSteven R Cummings - The Coordinating CenterIris Granek - Stony Brook UniversityJennifer Hays - Baylor College of MedicineGerardo Heiss - University of North Carolina at Chapel HillMargery Gass - University of CincinnatiSusan L Hendrix - Wayne State UniversityBarbara V Howard - Howard UniversityJudith Hsia - George Washington UniversityF. Allan Hubbell - University of California, IrvineKaren C Johnson - University of Tennessee Health Science CenterHoward Judd - The Ohio State UniversityJane Morley Kotchen - Medical College of WisconsinLewis H Kuller - University of PittsburghRobert D Langer - University of California San DiegoNorman L Lasser - Rutgers, The State University of New JerseyRobert B Wallace - University of IowaMarian C Limacher - University of Florida Health Science CenterShari Ludlam - National Institutes of HealthJoann E Manson - Harvard UniversityKaren L Margolis - The Ohio State UniversityJoan Mcgowan - National Institutes of HealthJudith K Ockene - University of Massachusetts BostonMary Jo O'SULLIVAN - The Ohio State UniversityLawrence Phillips - Emory UniversityRoss L Prentice - Fred Hutch Cancer CenterGloria E Sarto - University of Wisconsin–MadisonJohn Robbins - University of California, DavisMarcia L Stefanick - Stanford UniversityLinda VAN HORN - Northwestern UniversityJean WACTAWSKI-WENDE - Buffalo State UniversityEvelyn Whitlock - Kaiser PermanenteGarnet L Anderson - Fred Hutch Cancer CenterAnnlouise R Assaf - Brown UniversityDavid Barad - Yeshiva UniversityCora E Lewis - University of Alabama at BirminghamTamsen Bassford - University of ArizonaShirley A. A Beresford - University of WashingtonHenry R Black - Rush UniversityPatricia Blanchette - University of Hawaiʻi at MānoaWomen's Health Initiative Investigators
- Resource Type
- Journal article
- Publication Details
- The New England journal of medicine, Vol.354(7), pp.669-683
- DOI
- 10.1056/NEJMoa055218
- PMID
- 16481635
- NLM abbreviation
- N Engl J Med
- ISSN
- 0028-4793
- eISSN
- 1533-4406
- Publisher
- Massachusetts Medical Society
- Language
- English
- Date published
- 2006
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363594502771
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