Vitamin D3: The Evidence in Adults

Early French trial – Chapuy

Study details:1
Aim: to examine the effects of supplementation with vitamin D3 and calcium on the frequency of hip fractures and other nonvertebral fractures.
Patient study group: 3,270 healthy ambulatory women.

In the vitamin D3/calcium treated group vs. placebo:1

  • The number of hip fractures was 43% lower (p=0.043)
  • The total number of nonvertebral fractures was 32% lower (p=0.015)

Fractures Graphs

Pivotal US trial – Dawson-Hughes

Study details:2

Aim: to study the effects of three years of dietary supplementation with calcium and vitamin D on bone mineral density (BMD), biochemical measures of bone metabolism and the incidence of nonvertebral fractures.

Patient study group: 176 men and 213 women ≥65 years, living at home.

Over the three-year study period from baseline:2

  • Moderately reduced bone loss measured in the femoral neck, spine and total body
  • Reduced incidence of nonvertebral fractures

Study results

Recent 1 year intervention study – Hitz

Study details:3

Aim: to evaluate the effect of 1 year of treatment with calcium and vitamin D on bone mineral density (BMD) and bone markers in patients with a recent low-energy fracture. (Unlike other studies, these patients already had a low-energy fracture of the hip, forearm, shoulder or spine.)

Patient study group: 122 patients (84% female)

Following 1 year of treatment with calcium + vitamin D:3

  • Reduced bone turnover and significantly increased BMD in patients ≤70 years of age
  • Decreased bone loss in patients aged 70+
  • Patients with hip fracture showed the greatest increase in serum 25(OH)D from treatment: 25(OH)D increased from an insufficient concentration of 33nmol/L to 85nmol/L

Chart for change in BMD by age group

Meta-analysis - Bischoff-Ferrari

Man with Nurse

Bischoff-Ferrari’s 2009 meta-analysis demonstrated reductions in nonvertebral fractures with a high dose of vitamin D (482-770 IU/day) compared to lower doses of vitamin D (<400 IU/day)4:

  • 29% reduction in nonvertebral fractures in community-dwelling individuals
  • 15% reduction in nonvertebral fractures in institutionalised older individuals

The effect was dose dependent and independent of additional calcium supplementation.4

1. Chapuy MC et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. NEJM 1992; 327(23):1637-42.
2. Dawson-Hughes B et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. NEJM 1997; 337 (10):670-6.
3. Hitz MF et al. Bone mineral density and bone markers in patients with a recent low-energy fracture: effect of 1 year of treatment with calcium and vitamin D. Am J Clin Nutr 2007; 86(1):251-9.
4. Bischoff-Ferrari H et al. Prevention of Nonvertebral Fractures With Oral Vitamin D and Dose Dependency. Arch Intern Med. Vol 169 (No. 6) March 23, 2009.

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