Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

Authors: Jeffrey K C Lai, Robyn M Lucas, Mark S Clements, Andrew W Roddam, Emily Banks

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT) evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH) and hip fracture risk.

Methods

We undertook separate meta-analyses of RCTs examining vitamin D supplementation and hip fracture, and observational studies of serum vitamin D status (25-hydroxyvitamin D (25(OH)D) level), PTH and hip fracture. Results from RCTs were combined using the reported hazard ratios/relative risks (RR). Results from case-control studies were combined using the ratio of 25(OH)D and PTH measurements of hip fracture cases compared with controls. Original published studies of vitamin D, PTH and hip fracture were identified through PubMed and Web of Science databases, searches of reference lists and forward citations of key papers.

Results

The seven eligible RCTs identified showed no significant difference in hip fracture risk in those randomised to cholecalciferol or ergocalciferol supplementation versus placebo/control (RR = 1.13[95%CI 0.98-1.29]; 801 cases), with no significant difference between trials of <800 IU/day and ≥800 IU/day. The 17 identified case-control studies found 33% lower serum 25(OH)D levels in cases compared to controls, based on 1903 cases. This difference was significantly greater in studies with population-based compared to hospital-based controls (χ2 1 (heterogeneity) = 51.02, p < 0.001) and significant heterogeneity was present overall (χ2 16 (heterogeneity) = 137.9, p < 0.001). Serum PTH levels in hip fracture cases did not differ significantly from controls, based on ten case-control studies with 905 cases (χ2 9 (heterogeneity) = 149.68, p < 0.001).

Conclusions

Neither higher nor lower dose vitamin D supplementation prevented hip fracture. Randomised and observational data on vitamin D and hip fracture appear to differ. The reason for this is unclear; one possible explanation is uncontrolled confounding in observational studies. Post-fracture PTH levels are unrelated to hip fracture risk.
Appendix
Available only for authorised users
Literature
1.
Working Group of the Australian and New Zealand Bone and Mineral Society, Endocrine Society of Australia and Osteoporosis Australia: Vitamin D and adult bone health in Australia and New Zealand: a position statement. Med J Aust. 2005, 182 (6): 281-285.
2.
Bischoff-Ferrari HA: How to select the doses of vitamin D in the management of osteoporosis. Osteoporos Int. 2007, 18 (4): 401-407. 10.1007/s00198-006-0293-9.CrossRefPubMed
3.
Qaseem A, Snow V, Shekelle P, Hopkins R, Forciea MA, Owens DK: Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008, 149 (6): 404-415.CrossRefPubMed
4.
Avenell A, Gillespie WJ, Gillespie LD, O'Connell DL: Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database of Systematic Reviews. 2005, CD000227-3
5.
Avenell A, Gillespie WJ, Gillespie LD, O'Connell D: Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Systematic Reviews. 2009, CD000227-2
6.
Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B: Fracture prevention with vitamin D supplementation - A meta-analysis of randomized controlled trials. JAMA. 2005, 293 (18): 2257-2264. 10.1001/jama.293.18.2257.CrossRefPubMed
7.
Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J: Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009, 169 (6): 551-561. 10.1001/archinternmed.2008.600.CrossRefPubMed
8.
Chapuy MC, Arlot ME, Delmas PD, Meunier PJ: Effect of Calcium and Cholecalciferol Treatment for 3 Years on Hip-Fractures in Elderly Women. Br Med J. 1994, 308 (6936): 1081-1082.CrossRef
9.
DawsonHughes B, Harris SS, Krall EA, Dallal GE: Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997, 337 (10): 670-676. 10.1056/NEJM199709043371003.CrossRef
10.
Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ: Combined calcium and vitamin D-3 supplementation in elderly women: Confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: The Decalyos II study. Osteoporos Int. 2002, 13 (3): 257-264. 10.1007/s001980200023.CrossRefPubMed
11.
Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SAA, Black HR, Blanchette P, et al: Calcium plus vitamin D supplementation and the risk of fractures. Engl J Med. 2006, 354 (7): 669-683. 10.1056/NEJMoa055218.CrossRef
12.
Tang BMP, Eslick GD, Nowson C, Smith C, Bensoussan A: 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. 2007, 370 (9588): 657-666. 10.1016/S0140-6736(07)61342-7.CrossRefPubMed
13.
Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006, 17 (12): 1726-1733. 10.1007/s00198-006-0172-4.CrossRefPubMed
14.
Johnell O, Kanis J: Epidemiology of osteoporotic fractures. Osteoporos Int. 2005, 16 (Suppl 2): S3-7. 10.1007/s00198-004-1702-6.CrossRefPubMed
15.
Cooper C, Campion G, Melton LJ: Hip-Fractures in the Elderly - a Worldwide Projection. Osteoporos Int. 1992, 2 (6): 285-289. 10.1007/BF01623184.CrossRefPubMed
16.
Gullberg B, Johnell O, Kanis JA: World-wide projections for hip fracture. Osteoporos Int. 1997, 7 (5): 407-413. 10.1007/PL00004148.CrossRefPubMed
17.
Harvey N, Dennison E, Cooper C: Osteoporosis: impact on health and economics. Nat Rev Rheumatol. 6 (2): 99-105. 10.1038/nrrheum.2009.260.
18.
Shrier I, Boivin JF, Steele RJ, Platt RW, Furlan A, Kakuma R, Brophy J, Rossignol M: Should meta-analyses of interventions include observational studies in addition to randomized controlled trials? A critical examination of underlying principles. Am J Epidemiol. 2007, 166 (10): 1203-1209. 10.1093/aje/kwm189.CrossRefPubMed
19.
Martinez ME, delCampo MT, Garcia JA, SanchezCabezudo MJ, Medina S, Cimbrelo EG, Munuera L: Vitamin D concentrations in patients with hip fracture in Madrid Spain. Med Clin (Barc). 1996, 106 (2): 41-44.
20.
Mallen C, Peat G, Croft P: Quality assessment of observational studies is not commonplace in systematic reviews. J Clin Epidemiol. 2006, 59 (8): 765-769. 10.1016/j.jclinepi.2005.12.010.CrossRefPubMed
21.
Grant AM, Anderson FH, Avenell A, Campbell MK, Cooper C, Donaldson C, Francis RM, Gillespie WJ, Robinson CM, Torgerson DJ, et al: Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D RECORD): a randomised placebo-controlled trial. Lancet. 2005, 365 (9471): 1621-1628. 10.1016/S0140-6736(05)63013-9.CrossRefPubMed
22.
Lyons RA, Johansen A, Brophy S, Newcombe RG, Phillips CJ, Lervy B, Evans R, Wareham K, Stone MD: Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled trial of vitamin D supplementation. Osteoporos Int. 2007, 18 (6): 811-818. 10.1007/s00198-006-0309-5.CrossRefPubMed
23.
Cochran WG: The Combination of Estimates from Different Experiments. Biometrics. 1954, 10 (1): 101-129. 10.2307/3001666.CrossRef
24.
Cooper H, Hedges LV, (Eds.): The Handbook of Research Synthesis. 1994, New York: Russel Sage Foundation
25.
Higgins JPT, Thompson SG: Quantifying heterogeneity in a meta-analysis. Stat Med. 2002, 21 (11): 1539-1558. 10.1002/sim.1186.CrossRefPubMed
26.
Egger M, Smith GD, Schneider M, Minder C: Bias in meta-analysis detected by a simple graphical test. Br Med J. 1997, 315 (7109): 629-634.CrossRef
27.
Higgins JP, White IR, Anzures-Cabrera J: Meta-analysis of skewed data: combining results reported on log-transformed or raw scales. Stat Med. 2008, 27 (29): 6072-6092. 10.1002/sim.3427.CrossRefPubMedPubMedCentral
28.
Team RDC: R: A Language and Environment for Statistical Computing. 2.5.1 edition. 2007, Vienna Austria R Foundation for Statistical Computing
29.
Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM: Vitamin D supplementation and fracture incidence in elderly persons - A randomized placebo-controlled clinical trial. Ann Intern Med. 1996, 124 (4): 400-&.CrossRefPubMed
30.
Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI: Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res. 2002, 17 (4): 709-715. 10.1359/jbmr.2002.17.4.709.CrossRefPubMed
31.
Trivedi DP, Doll R, Khaw KT: Effect of four monthly oral vitamin D-3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community randomised double blind controlled trial. Br Med J. 2003, 326 (7387): 469-472. 10.1136/bmj.326.7387.469.CrossRef
32.
Law M, Withers H, Morris J, Anderson F: Vitamin D supplementation and the prevention of fractures and falls results of a randomised trial in elderly people in residential accommodation. Age Ageing. 2006, 35 (5): 482-486. 10.1093/ageing/afj080.CrossRefPubMed
33.
Smith H, Anderson F, Raphael H, Maslin P, Crozier S, Cooper C: Effect of annual intramuscular vitamin D on fracture risk in elderly men and womena population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford). 2007, 46 (12): 1852-1857. 10.1093/rheumatology/kem240.CrossRef
34.
Lund B, Sorensen OH, Christensen AB: 25-Hydroxycholecalciferol and Fractures of Proximal Femur. Lancet. 1975, 2 (7929): 300-302. 10.1016/S0140-6736(75)92732-4.CrossRefPubMed
35.
Baker MR, McDonnell H, Peacock M, Nordin BEC: Plasma 25-Hydroxy Vitamin-D Concentrations in Patients with Fractures of the Femoral-Neck. Br Med J. 1979, 1 (6163): 589-589. 10.1136/bmj.1.6163.589.CrossRefPubMedPubMedCentral
36.
Hoikka V, Alhava EM, Savolainen K, Parviainen M: Osteomalacia in Fractures of the Proximal Femur. Acta Orthop Scand. 1982, 53 (2): 255-260. 10.3109/17453678208992212.CrossRefPubMed
37.
Vonknorring J, Slatis P, Weber TH, Helenius T: Serum Levels of 25-Hydroxyvitamin-D, 24,25-Dihydroxyvitamin-D and Parathyroid-Hormone in Patients with Femoral-Neck Fracture in Southern Finland. Clin Endocrinol (Oxford). 1982, 17 (2): 189-194. 10.1111/j.1365-2265.1982.tb01578.x.CrossRef
38.
Morris HA, Morrison GW, Burr M, Thomas DW, Nordin BEC: Vitamin-D and Femoral-Neck Fractures in Elderly South Australian Women. Med J Aust. 1984, 140 (9): 519-521.PubMed
39.
Lips P, van Ginkel FC, Jongen MJ, Rubertus F, van der Vijgh WJ, Netelenbos JC: Determinants of vitamin D status in patients with hip fracture and in elderly control subjects. Am J Clin Nutr. 1987, 46 (6): 1005-1010.PubMed
40.
Lau EMC, Woo J, Swaminathan R, Macdonald D, Donnan SPB: Plasma 25-Hydroxyvitamin-D Concentration in Patients with Hip Fracture in Hong-Kong. Gerontology. 1989, 35 (4): 198-204. 10.1159/000213023.CrossRefPubMed
41.
Pun KK, Wong FHW, Wang C, Lau P, Ho PWM, Pun WK, Chow SP, Cheng CL, Leong JCY, Young RTT: Vitamin-D Status among Patients with Fractured Neck of Femur in Hong-Kong. Bone. 1990, 11 (5): 365-368. 10.1016/8756-3282(90)90092-D.CrossRefPubMed
42.
Macdonald D, Lau E, Chan ELP, Mak T, Woo J, Leung PC, Swaminathan R: Serum Intact Parathyroid-Hormone Levels in Elderly Chinese Females with Hip Fracture. Calcif Tissue Int. 1992, 51 (6): 412-414. 10.1007/BF00296672.CrossRefPubMed
43.
Benhamou CL, Tourliere D, Gauvain JB, Picaper G, Audran M, Jallet P: Calciotropic Hormones in Elderly People with and without Hip Fracture. Osteoporos Int. 1995, 5 (2): 103-107. 10.1007/BF01623311.CrossRefPubMed
44.
Boonen S, Broos P, Verbeke G, Aerssens J, VanHerck E, Jans I, Dequeker J, Bouillon R: Calciotropic hormones and markers of bone remodeling in age-related (type II) femoral neck osteoporosis Alterations consistent with secondary hyperparathyroidism-induced bone resorption. Journals of Gerontology Series a-Biological Sciences and Medical Sciences. 1997, 52 (5): M286-M293.CrossRef
45.
Thiebaud D, Burckhardt P, Costanza M, Sloutskis D, Gilliard D, Quinodoz F, Jacquet AF, Burnand B: Importance of albumin 25(OH)-vitamin D and IGFBP-3 as risk factors in elderly women and men with hip fracture. Osteoporos Int. 1997, 7 (5): 457-462. 10.1007/s001980050033.CrossRefPubMed
46.
Di Monaco M, Vallero F, Di Monaco R, Mautino F, Cavanna A: Primary hyperparathyroidism in elderly patients with hip fracture. J Bone Miner Metab. 2004, 22 (5): 491-495.CrossRefPubMed
47.
Nuti R, Martini G, Valenti R, Gambera D, Gennari L, Salvadori S, Avanzati A: Vitamin D status and bone turnover in women with acute hip fracture. Clin Orthop. 2004, 208-213. 422
48.
Bakhtiyarova S, Lesnyak O, Kyznesova N, Blankenstein MA, Lips P: Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg Russia. Osteoporos Int. 2006, 17 (3): 441-446. 10.1007/s00198-005-0006-9.CrossRefPubMed
49.
Giusti A, Barone A, Razzano M, Pizzonia M, Oliveri M, Palummeri E, Pioli G: High prevalence of secondary hyperparathyroidism due to hypovitaminosis D in hospitalized elderly with and without hip fracture. J Endocrinol Invest. 2006, 29 (9): 809-813.CrossRefPubMed
50.
Sakuma M, Endo N, Oinuma T, Hayami T, Endo E, Yazawa T, Watanabe K, Watanabe S: Vitamin D and intact PTH status in patients with hip fracture. Osteoporos Int. 2006, 17 (11): 1608-1614. 10.1007/s00198-006-0167-1.CrossRefPubMed
51.
Cummings SR, Browner WS, Bauer D, Stone K, Ensrud K, Jamal S, Ettinger B: Endogenous hormones and the risk of hip and vertebral fractures among older women. N Engl J Med. 1998, 339 (11): 733-738. 10.1056/NEJM199809103391104.CrossRefPubMed
52.
Cauley JA, LaCroix AZ, Wu L, Horwitz M, Danielson ME, Bauer DC, Lee JS, Jackson RD, Robbins JA, Wu C, et al: Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Ann Intern Med. 2008, 149 (4): 242-250.CrossRefPubMedPubMedCentral
53.
Looker AC, Mussolino ME: Serum 25-hydroxyvitamin D and hip fracture risk in older US white adults. J Bone Miner Res. 2008, 23 (1): 143-150. 10.1359/jbmr.071003.CrossRefPubMed
54.
Lai JK, Lucas RM, Clements MS, Harrison SL, Banks E: Assessing vitamin D status pitfalls for the unwary. Mol Nutr Food Res. 2010,
55.
DIPART Group: Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ. 2010, 340: b5463-10.1136/bmj.b5463.CrossRef
56.
Lips P: Vitamin D deficiency and secondary hyperparathyroidism in the elderly Consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001, 22 (4): 477-501. 10.1210/er.22.4.477.CrossRefPubMed
57.
58.
Ng K, Stjohn A, Bruce DG: Secondary Hyperparathyroidism Vitamin-D Deficiency and Hip Fracture - Importance of Sampling Times after Fracture. Bone Miner. 1994, 25 (2): 103-109. 10.1016/S0169-6009(08)80252-8.CrossRefPubMed
59.
Dubin NH, Monahan LK, Yu-Yahiro JA, Michael RH, Zimmerman SI, Hawkes W, Hebel JR, Fox KM, Magaziner J: Serum concentrations of steroids parathyroid hormone and calcitonin in postmenopausal women during the year following hip fracture Effect of location of fracture and age. Journals of Gerontology Series a-Biological Sciences and Medical Sciences. 1999, 54 (9): M467-M473.CrossRef
60.
Johansen A, Stone MD, Omahony MS, Westlake H, Woodhead JS, Woodhouse KW: Reliability of parathyroid hormone measurements in the period immediately following hip fracture. Age Ageing. 1997, 26 (3): 175-178. 10.1093/ageing/26.3.175.CrossRefPubMed
61.
Lips P: Which circulating level of 25-hydroxyvitamin D is appropriate?. J Steroid Biochem Mol Biol. 2004, 89-90 (1-5): 611-614. 10.1016/j.jsbmb.2004.03.040.CrossRefPubMed
62.
Huncharek M, Muscat J, Kupelnick B: Dairy products dietary calcium and vitamin D intake as risk factors for prostate cancer A meta-analysis of 26,769 cases from 45 observational studies. Nutrition and Cancer-an International Journal. 2008, 60 (4): 421-441. 10.1080/01635580801911779.CrossRef
63.
Abbas S, Chang-Claude J, Linseisen J: Plasma 25-hydroxyvitamin D and premenopausal breast cancer risk in a German case-control study. Int J Cancer. 2009, 124 (1): 250-255. 10.1002/ijc.23904.CrossRefPubMed
64.
Blackmore KM, Lesosky M, Barnett H, Raboud JM, Vieth R, Knight JA: Vitamin D from dietary intake and sunlight exposure and the risk of hormone-receptor-defined breast cancer. Am J Epidemiol. 2008, 168 (8): 915-924. 10.1093/aje/kwn198.CrossRefPubMed
65.
Mathieu C, Gysemans C, Giulietti A, Bouillon R: Vitamin D and diabetes. Diabetologia. 2005, 48 (7): 1247-1257. 10.1007/s00125-005-1802-7.CrossRefPubMed
66.
Forman JP, Curhan GC, Taylor EN: Plasma 25-hydroxyvitamin D levels and risk of incident hypertension among young women. Hypertension. 2008, 52 (5): 828-832. 10.1161/HYPERTENSIONAHA.108.117630.CrossRefPubMedPubMedCentral
67.
Munger KL, Zhang SM, O'Reilly E, Hernan MA, Olek MJ, Willett WC, Ascherio A: Vitamin D intake and incidence of multiple sclerosis. Neurology. 2004, 62 (1): 60-65.CrossRefPubMed
68.
Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A: Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006, 296 (23): 2832-2838. 10.1001/jama.296.23.2832.CrossRefPubMed
69.
Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C, Barnhill R: Sun exposure and mortality from melanoma. J Natl Cancer Inst. 2005, 97 (3): 195-199. 10.1093/jnci/dji019.CrossRefPubMed
70.
Peto R, Doll R, Buckley JD, Sporn MB: Can Dietary Beta-Carotene Materially Reduce Human Cancer Rates. Nature. 1981, 290 (5803): 201-208. 10.1038/290201a0.CrossRefPubMed
71.
Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, Belanger C, LaMotte F, Gaziano JM, Ridker PM, et al: Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med. 1996, 334 (18): 1145-1149. 10.1056/NEJM199605023341801.CrossRefPubMed
72.
The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group: The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994, 330 (15): 1029-1035. 10.1056/NEJM199404143301501.CrossRef
73.
Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL, Valanis B, Williams JH, et al: Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996, 334 (18): 1150-1155. 10.1056/NEJM199605023341802.CrossRefPubMed
74.
Lauridsen AL, Vestergaard P, Hermann AP, Brot C, Heickendorff L, Mosekilde L, Nexo E: Plasma concentrations of 25-hydroxy-vitamin D and 1,25-dihydroxy-vitamin D are related to the phenotype of Gc (vitamin D-binding protein) A cross-sectional study on 595 - Early postmenopausal women. Calcif Tissue Int. 2005, 77 (1): 15-22. 10.1007/s00223-004-0227-5.CrossRefPubMed
75.
Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D, Chang-Claude J: The Gc2 allele of the vitamin D binding protein is associated with a decreased postmenopausal breast cancer risk independent of the vitamin D status. Cancer Epidemiology Biomarkers & Prevention. 2008, 17 (6): 1339-1343. 10.1158/1055-9965.EPI-08-0162.CrossRef
76.
Orton SM, Morris AP, Herrera BM, Ramagopalan SV, Lincoln MR, Chao MJ, Vieth R, Sadovnick AD, Ebers GC: Evidence for genetic regulation of vitamin D status in twins with multiple sclerosis. Am J Clin Nutr. 2008, 88 (2): 441-447.PubMedPubMedCentral
Metadata
Title
Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies
Authors
Jeffrey K C Lai
Robyn M Lucas
Mark S Clements
Andrew W Roddam
Emily Banks
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-331

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue

Study protocol

Motivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4-8 year old children: design of the MInT study

Research article

A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

Research article

The population approach to falls injury prevention in older people: findings of a two community trial

Research article

Lower age at menarche affects survival in older Australian women: results from the Australian Longitudinal Study of Ageing

Research article

Prejudice and misconceptions about tuberculosis and HIV in rural and urban communities in Ethiopia: a challenge for the TB/HIV control program

Research article

Comparing two service delivery models for the prevention of mother-to-child transmission (PMTCT) of HIV during transition from single-dose nevirapine to multi-drug antiretroviral regimens