Effects of Calcium and Vitamin D Supplementation on Hip Bone Mineral Density and Calcium-Related Analytes in Elderly Ambulatory Australian Women : A five-Year Ramdomized Controlled Trial

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Abstract

Context: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported.Objective: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes.Design, Setting, and Participants: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr.Interventions: The interventions were 1200mg/d calcium with placebo vitamin D(Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo ( control).Main Outcome Measures: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured.Results: Hip BMD was preserved in CaD (- 0.17%) and Ca (0.19%) groups but not controls (- 1.27%) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median ( 68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3% lower plasma alkaline phosphatase, respectively ( P <= 0.02), and 28.7 and 34.5% lower urinary deoxypyridinoline to creatinine ratio, respectively ( P <= 0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3%, P <= 0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads.Conclusions: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.
Original languageEnglish
Pages (from-to)online - approx 5-20pp
JournalJournal of Clinical Endocrinology and Metabolism
Volume93
Issue number3
DOIs
Publication statusPublished - 2008

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Pelvic Bones
Vitamin D
Bone Density
Minerals
Bone
Calcium
Bone Remodeling
Intestinal Absorption
Climate
Placebos
Ergocalciferols
Independent Living
Plasma density
Biomarkers
Alkaline Phosphatase
Hip
Creatinine
X-Rays
Outcome Assessment (Health Care)
Bone and Bones

Cite this

@article{f8a65c0159b94fa9847546c3858583c0,
title = "Effects of Calcium and Vitamin D Supplementation on Hip Bone Mineral Density and Calcium-Related Analytes in Elderly Ambulatory Australian Women : A five-Year Ramdomized Controlled Trial",
abstract = "Context: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported.Objective: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes.Design, Setting, and Participants: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr.Interventions: The interventions were 1200mg/d calcium with placebo vitamin D(Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo ( control).Main Outcome Measures: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured.Results: Hip BMD was preserved in CaD (- 0.17{\%}) and Ca (0.19{\%}) groups but not controls (- 1.27{\%}) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median ( 68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3{\%} lower plasma alkaline phosphatase, respectively ( P <= 0.02), and 28.7 and 34.5{\%} lower urinary deoxypyridinoline to creatinine ratio, respectively ( P <= 0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3{\%}, P <= 0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads.Conclusions: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.",
author = "Kun Zhu and A. Devine and Ian Dick and Scott Wilson and Richard Prince",
year = "2008",
doi = "10.1210/jc.2007-1466",
language = "English",
volume = "93",
pages = "online -- approx 5--20pp",
journal = "Journal of Endocrinology & Metabolism",
issn = "0021-972X",
publisher = "ENDOCRINE SOC",
number = "3",

}

TY - JOUR

T1 - Effects of Calcium and Vitamin D Supplementation on Hip Bone Mineral Density and Calcium-Related Analytes in Elderly Ambulatory Australian Women : A five-Year Ramdomized Controlled Trial

AU - Zhu, Kun

AU - Devine, A.

AU - Dick, Ian

AU - Wilson, Scott

AU - Prince, Richard

PY - 2008

Y1 - 2008

N2 - Context: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported.Objective: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes.Design, Setting, and Participants: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr.Interventions: The interventions were 1200mg/d calcium with placebo vitamin D(Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo ( control).Main Outcome Measures: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured.Results: Hip BMD was preserved in CaD (- 0.17%) and Ca (0.19%) groups but not controls (- 1.27%) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median ( 68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3% lower plasma alkaline phosphatase, respectively ( P <= 0.02), and 28.7 and 34.5% lower urinary deoxypyridinoline to creatinine ratio, respectively ( P <= 0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3%, P <= 0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads.Conclusions: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.

AB - Context: Effects of long-term calcium, with or without vitamin D, on hip bone mineral density (BMD) and bone turnover in sunny climates have not been reported.Objective: The aim was to evaluate the effect of vitamin D added to calcium supplementation on hip dual-energy x-ray absorptiometry BMD and calcium-related analytes.Design, Setting, and Participants: The study was a 5-yr randomized, controlled, double-blind trial of 120 community-dwelling women aged 70-80 yr.Interventions: The interventions were 1200mg/d calcium with placebo vitamin D(Ca group) or with 1000 IU/d vitamin D2 (CaD group), or double placebo ( control).Main Outcome Measures: Hip BMD, plasma 25-hydroxyvitamin D, biomarkers of bone turnover, PTH, and intestinal calcium absorption were measured.Results: Hip BMD was preserved in CaD (- 0.17%) and Ca (0.19%) groups but not controls (- 1.27%) at yr 1 and maintained in the CaD group only at yr 3 and 5. The beneficial effects were mainly in those with baseline 25-hydroxyvitamin D levels below the median ( 68 nmol/liter). At yr 1, compared with controls, the Ca and CaD groups had 6.8 and 11.3% lower plasma alkaline phosphatase, respectively ( P <= 0.02), and 28.7 and 34.5% lower urinary deoxypyridinoline to creatinine ratio, respectively ( P <= 0.05). At 5 yr, this suppression was maintained only in the CaD group. CaD reduced PTH at 3 and 5 yr cf. controls (27.8 and 31.3%, P <= 0.005) in those with baseline PTH levels above the median (3.6 pmol/liter). Therapy did not affect intestinal calcium absorption at high carrier loads.Conclusions: Addition of vitamin D to calcium has long-term beneficial effects on bone density in elderly women living in a sunny climate, probably mediated by a long-term reduction in bone turnover rate.

U2 - 10.1210/jc.2007-1466

DO - 10.1210/jc.2007-1466

M3 - Article

VL - 93

SP - online - approx 5-20pp

JO - Journal of Endocrinology & Metabolism

JF - Journal of Endocrinology & Metabolism

SN - 0021-972X

IS - 3

ER -