Calcium plus vitamin D supplementation and the risk of fractures
Department of Medicine, Division of Preventive and Behavioral Medicine
Aged; Bone Density; Calcium; Calcium Carbonate; Double-Blind Method; Drug Combinations; Drug Interactions; Estrogen Replacement Therapy; Female; Follow-Up Studies; Fractures, Bone; Hip Fractures; Humans; Kidney Calculi; Middle Aged; Patient Compliance; Postmenopause; Proportional Hazards Models; Risk; Spinal Fractures; Vitamin D
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 [corrected] 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 (PCONCLUSIONS: 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.).
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Citation: N Engl J Med. 2006 Feb 16;354(7):669-83. Link to article on publisher's site
Jackson, Rebecca D.; LaCroix, Andrea Z.; Gass, Margery; Wallace, Robert B.; Robbins, John; Lewis, Cora E.; Bassford, Tamsen; Beresford, Shirley A. A.; Black, Henry R.; Blanchette, Patricia L.; Bonds, Denise E.; Brunner, Robert L.; Brzyski, Robert G.; Caan, Bette J.; Cauley, Jane A.; Chlebowski, Rowan T.; Cummings, Steven R.; Granek, Iris A.; Hays, Jennifer; Heiss, Gerardo; Hendrix, Susan L.; Howard, Barbara V.; Hsia, Judith; Hubbell, F. Allan; Johnson, Karen C.; Judd, Howard; Kotchen, Jane Morley; Kuller, Lewis H.; Langer, Robert D.; Lasser, Norman L.; Limacher, Marian C.; Ludlam, Shari E.; Manson, JoAnn E.; Margolis, Karen L.; McGowan, Joan; Ockene, Judith K.; O'Sullivan, Mary Jo; Phillips, Lawrence; Prentice, Ross L.; Sarto, Gloria E.; Stefanick, Marcia L.; Van Horn, Linda; Wactawski-Wende, Jean; Whitlock, Evelyn; Anderson, Garnet L.; Assaf, Annlouise R.; and Barad, David H., "Calcium plus vitamin D supplementation and the risk of fractures" (2006). Women’s Health Research Faculty Publications. 436.