Top

Published in:

01-12-2010 | Original Article

Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71 years: a 3-year randomized population-based trial (OSTPRE-FPS)

Authors: M. Kärkkäinen, M. Tuppurainen, K. Salovaara, L. Sandini, T. Rikkonen, J. Sirola, R. Honkanen, J. Jurvelin, E. Alhava, H. Kröger

Published in: Osteoporosis International | Issue 12/2010

Abstract

Summary

The Osteoporosis Risk Factor and Prevention-Fracture Prevention Study (OSTPRE-FPS) was a randomized population-based open trial (n = 593). The supplementation group (n = 287) received daily cholecalciferol 800 IU + calcium 1,000 mg for 3 years while the control group (n = 306) received neither supplementation nor placebo. Daily vitamin D and calcium supplementation have a positive effect on the skeleton in ambulatory postmenopausal women.

Introduction

Vitamin D deficiency is common in the elderly, and vitamin D levels are associated with low bone mineral density (BMD). The working hypothesis was that vitamin D and calcium supplementation could prevent bone loss in ambulatory postmenopausal women.

Methods

The OSTPRE-FPS was a randomized population-based open trial with a 3-year follow-up in 3,432 women (aged 66 to 71 years). A randomly selected subsample of 593 subjects underwent BMD measurements. The supplementation group (n = 287) received daily cholecalciferol 800 IU + calcium 1,000 mg for 3 years while the control group (n = 306) received neither supplementation nor placebo.

Results

In the intention-to-treat analysis, total body BMD (n = 362) increased significantly more in the intervention group than in the control group (0.84% vs. 0.19%, p = 0.011). The BMD change differences at the lumbar spine (p = 0.372), femoral neck (p = 0.188), trochanter (p = 0.085), and total proximal femur (p = 0.070) were statistically nonsignificant. Analyses in compliant women (≥80% of use) resulted in stronger and statistically significant effects at the total body and femoral regions.

Conclusion

Daily vitamin D and calcium supplementation have a positive effect on the skeleton in ambulatory postmenopausal women with adequate nutritional calcium intake.

Bischoff-Ferrari HA, Giovannucci E, Willet WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28 [Erratum, Am J Clin Nutr 2006;84:1253]PubMed

Heaney RP, Dowell MS, Hale CA, Bendich A (2003) Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22:142–146PubMed

Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501CrossRefPubMed

Larsen ER, Mosekilde L, Foldspang A (2004) Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population-based 3-year intervention study. J Bone Miner Res 19:370–378CrossRefPubMed

Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 327:1637–1642CrossRefPubMed

Venning G (2005) Recent developments in vitamin D deficiency and muscle weakness among elderly people. BMJ 330(7490):524–526CrossRefPubMed

Margiloff L, Harris SS, Lee S, Lechan R, Dawson-Hughes B (2001) Vitamin D status of an outpatient clinic population. Calcif Tissue Int 69(5):263–267CrossRefPubMed

Lamberg-Allardt CJ, Outila TA, Karkkainen MU, Rita HJ, Valsta LM (2001) Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? J Bone Miner Res 16(11):2066–2073CrossRefPubMed

Gloth FM 3rd, Gundberg CM, Hollis BW, Haddad JG Jr, Tobin JD (1995) Vitamin D deficiency in homebound elderly persons. JAMA 274(21):1683–1686CrossRefPubMed

10.

Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716CrossRefPubMed

11.

Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370:657–666CrossRefPubMed

12.

Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SA, Black HR, Blanchette P, Bonds DE, Brunner RL, Brzyski RG, Caan B, Cauley JA, Chlebowski RT, Cummings SR, Granek I, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Johnson KC, Judd H, Kotchen JM, Kuller LH, Langer RD, Lasser NL, Limacher MC, Ludlam S, Manson JE, Margolis KL, McGowan J, Ockene JK, O’Sullivan MJ, Phillips L, Prentice RL, Sarto GE, Stefanick ML, Van Horn L, Wactawski-Wende J, Whitlock E, Anderson GL, Assaf AR, Barad D, Women’s Health Initiative Investigators (2006) Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354(7):669–683CrossRefPubMed

13.

Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670–676CrossRefPubMed

14.

Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13(3):257–264CrossRefPubMed

15.

Zhu K, Bruce D, Austin N, Devine A, Ebeling PR, Prince RL (2008) A randomized controlled trial of the effects of calcium with or without vitamin D on bone structure and bone related chemistry in elderly women with vitamin D insufficiency. J Bone Miner Res 23(8):1343–1348CrossRefPubMed

16.

Chel V, Wijnhoven HAH, Smit JH, Ooms M, Lips P (2008) Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents. Osteoporos Int 19:663–671CrossRefPubMed

17.

Honkanen R, Alhava EM, Saarikoski S, Tuppurainen M (1991) Osteoporosis risk factors in perimenopausal women. Calcif Tissue Int 49(Suppl):S74–75CrossRefPubMed

18.

Honkanen R et al (1996) Does lactose intolerance predispose to low bone density? A population-based study of perimenopausal Finnish women. Bone 19:23–28CrossRefPubMed

19.

Jones G, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–695PubMed

20.

Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281CrossRefPubMed

21.

Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–695PubMed

22.

Greenspan SL, Maitland LA, Myers ER, Krasnow MB, Kido TH (1994) Femoral bone loss progresses with age: a longitudinal study in women over age 65. J Bone Miner Res 9:1959–1965CrossRefPubMed

23.

Daly RM, Bass S, Nowson C (2006) Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men. Bone 39(4):946–953CrossRefPubMed

24.

Reid IR, Mason B, Horne A, Ames R, Reid HE, Bava U, Bolland MJ, Gamble GD (2006) Randomized controlled trial of calcium in healthy older women. Am J Med 119:777–785CrossRefPubMed

25.

Roux C, Bischoff-Ferrari HA, Papapoulos SE, de Papp AE, West JA, Bouillon R (2008) New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion. Curr Med Res Opin 24(5):1363–1370CrossRefPubMed

26.

Bacon CJ, Gamble GD, Horne AM, Scott MA, Reid IR (2009) High-dose oral vitamin D3 supplementation in the elderly. Osteoporos Int 20:1407–1415CrossRefPubMed

27.

Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G (1991) Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 115(7):505–512PubMed

28.

Meier C, Woitge HW, Witte K, Lemmer B, Seibel MJ (2004) Supplementation with oral vitamin D3 and calcium during winter prevents seasonal bone loss: a randomized controlled open-label prospective trial. J Bone Miner Res 19:1221–1230CrossRefPubMed

29.

Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294(18):2336–2341CrossRefPubMed

30.

Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (2000) Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr 72:745–750PubMed

31.

Adami S, Giannini S, Bianchi G, Siningaglia L (2009) Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos Int 20(2):239–244CrossRefPubMed

32.

Ireland P, Fordtran JS (1973) Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. J Clin Invest 52:2672–2681CrossRefPubMed

33.

Bischoff-Ferrari HA (2007) How to select the doses of vitamin D in the management of osteoporosis. Osteoporos Int 18:401–407CrossRefPubMed

34.

Dawson-Hughes B, Bischoff-Ferrari HA (2007) Therapy of osteoporosis with calcium and vitamin D. Suppl 22:V59–63

35.

Bolland MJ, Barber PA, Doughty RN, Mason B, Horne A, Ames R, Gamble GD, Grey A, Reid IR (2008) Vascular events in healthy older women receiving calcium supplementation: randomized controlled trial. BMJ 336:262–266CrossRefPubMed

36.

Pentti K, Tuppurainen MT, Honkanen R, Sandini L, Kröger H, Alhava E, Saarikoski S (2009) Use of calcium supplements and the risk of coronary heart disease in 52–62-year-old women: the Kuopio osteoporosis risk factor and prevention study. Maturitas 63(1):73–78CrossRefPubMed

37.

Bischoff-Ferrari HA, Kiel DP, Dawson-Hughes B, Orav JE, Li R, Spiegelman D, Dietrich T, Willett WC (2009) Dietary calcium and serum 25-hydroxyvitamin D status in relation to bone mineral density among U.S. adults. J Bone Miner Res 24(5):935–942CrossRefPubMed

38.

Lamberg-Allardt C, Viljakainen H & Working Group. Follow-up study on the vitamin D status in the Finnish population 2002 and 2004. In Reports of the Ministry of Social Affairs and Health, Helsinki, Finland 2006: Ministry of Social Affairs and Health, pp 1–49

Title: Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71 years: a 3-year randomized population-based trial (OSTPRE-FPS)
Authors: M. Kärkkäinen
M. Tuppurainen
K. Salovaara
L. Sandini
T. Rikkonen
J. Sirola
R. Honkanen
J. Jurvelin
E. Alhava
H. Kröger
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 12/2010
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-009-1167-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71 years: a 3-year randomized population-based trial (OSTPRE-FPS)

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2010

Effect of whole-body vibration on BMD: a systematic review and meta-analysis

Laser 904 nm action on bone repair in rats with osteoporosis

Positive impact of compliance to strontium ranelate on the risk of nonvertebral osteoporotic fractures

Reduced cortical bone density with normal trabecular bone density in girls with Turner syndrome

Risk of subsequent fracture and mortality within 5 years after a non-vertebral fracture

To investigate the role of the nervous system of bone in steroid-induced osteonecrosis in rabbits