Comparisons of different vitamin D supplementation for prevention of osteoporotic fractures: a Bayesian network meta-analysis and meta-regression of randomised controlled trials

Li, Shuo; Xi, Chunyang; Li, Liangliang; Long, Zhiping; Zhang, Nannan; Yin, Huihui; Xie, Kun; Wu, Zhiyong; Tian, Jingshen; Wang, Fan; Wang, Maoqing

doi:10.1080/09637486.2020.1830264

Cited by 15 publications

(16 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While it is beyond the scope of our work to release detailed recommendations regarding calcium supplementation in osteoporosis patients, we wish to point out that a recent RCT with the bisphosphonate zoledronate showed excellent anti-fracture effects in patients using pure vitamin D supplementation without additional calcium supplements but consuming 1g of calcium daily by a usual diet [ 90 ]. These data may suggest that, even in osteoporosis patients, vitamin D treatment without additional calcium supplements may be sufficient in the case of adequate dietary calcium intake, but this issue is still not clarified in the scientific community, since it is challenging to disentangle the effects of vitamin D and calcium with regards to bone health [ 5 , 88 , 90 , 91 , 92 ]. Of note, increasing calcium and protein intake by milk, yoghurt, and cheese significantly reduces the risk of falls and fractures in aged care residents [ 93 ].…”

Section: Consensus Recommendationsmentioning

confidence: 99%

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

et al. 2022

View full text Add to dashboard Cite

Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin D guidelines, with respect to the diagnosis and treatment of vitamin D deficiency. We aimed to address this issue by providing respective recommendations for adults, developed by a European expert panel, using the Delphi method to reach consensus. Increasing the awareness of vitamin D deficiency and efforts to harmonize vitamin D guidelines should be pursued. We argue against a general screening for vitamin D deficiency but suggest 25-hydroxyvitamin D (25(OH)D) testing in certain risk groups. We recommend a vitamin D supplementation dose of 800 to 2000 international units (IU) per day for adults who want to ensure a sufficient vitamin D status. These doses are also recommended for the treatment of vitamin D deficiency, but higher vitamin D doses (e.g., 6000 IU per day) may be used for the first 4 to 12 weeks of treatment if a rapid correction of vitamin D deficiency is clinically indicated before continuing, with a maintenance dose of 800 to 2000 IU per day. Treatment success may be evaluated after at least 6 to 12 weeks in certain risk groups (e.g., patients with malabsorption syndromes) by measurement of serum 25(OH)D, with the aim to target concentrations of 30 to 50 ng/mL (75 to 125 nmol/L).

show abstract

Section: Consensus Recommendationsmentioning

confidence: 99%

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

et al. 2022

View full text Add to dashboard Cite

show abstract

“…[ 22 ] A recent Bayesian network meta-analysis and meta-regression demonstrated that vitamin D supplementation does not affect risk of fractures, while supplementation with vitamin D together with calcium may have a beneficial effect for fracture prevention. [ 23 ] High concentrations of maternal vitamin D may increase the bone mineral density for adults, [ 24 ] the vitamin D dose needs to be further confirmed. Vegetables and fruits are considered major natural sources of vitamins, which may be beneficial for bone health.…”

Section: Resultsmentioning

confidence: 99%

The relationship between healthy lifestyles and bone health

Sheng

Nüssler³

et al. 2021

Medicine

View full text Add to dashboard Cite

Background Bone health, especially osteoporosis among ageing populations, has become an important topic for both clinical and basic researchers. The relationship between bone health and healthy lifestyles has been frequently discussed. The present study focuses on the relationship between bone health and healthy lifestyles among older adults, based on a global comparison. Methods This narrative review was performed by collecting clinical trials, basic research and reviews on lifestyle and bone health in PubMed database. Results Positive effects of physical activity and negative effects of malnutrition, alcohol abuse, and cigarette smoking on bone health were revealed. The relationship between bone health and drinking coffee and tea is still inconclusive. Moreover, the diversity of each region should be aware when considering healthy lifestyles to improve bone health. Conclusion Healthy lifestyles are highly related to bone health, and different lifestyles may have different influences on regions with a high risk of bone diseases. It is practical to acknowledge the diversity of economic, religious, environmental and geological conditions in each region when providing suitable and effective recommendations for healthy lifestyles that can improve overall bone health.

show abstract

“…It is also crucial to outline the knowledge provided by meta-analyses of RCTs that have partially considered the evidence provided by the above-mentioned trials [10,11,[61][62][63][64][65][66][67].…”

Section: Meta-analyses Of Vitamin D Rctsmentioning

confidence: 99%

“…Of note, explorative data from the MDIG trial reported three radiographically confirmed cases of rickets in the placebo group and just one case in the intervention groups that included four times more patients than the placebo group did overall [30]. Regarding other musculoskeletal health outcomes, i.e., fractures, falls, and BMD, the conclusions from meta-analyses of the RCTs are inconsistent and puzzling [10,14,[63][64][65]. While some meta-analyses conclude that vitamin D supplementation per se does not prevent fractures and falls or has meaningful effects on BMD, there are other meta-analyses documenting fracture prevention by daily combined calcium plus vitamin D supplementation in older adults [10,14,[63][64][65].…”

Section: Meta-analyses Of Vitamin D Rctsmentioning

confidence: 99%

“…Regarding other musculoskeletal health outcomes, i.e., fractures, falls, and BMD, the conclusions from meta-analyses of the RCTs are inconsistent and puzzling [10,14,[63][64][65]. While some meta-analyses conclude that vitamin D supplementation per se does not prevent fractures and falls or has meaningful effects on BMD, there are other meta-analyses documenting fracture prevention by daily combined calcium plus vitamin D supplementation in older adults [10,14,[63][64][65]. Data interpretation has to consider evidence for a U-shaped effect, as high vitamin D bolus doses increase the risk of fractures and falls, whereas any beneficial effects, if present, are particularly observed with moderate vitamin D doses of about 800 IU per day in older individuals with a poor vitamin D status [10,14,[63][64][65].…”

Section: Meta-analyses Of Vitamin D Rctsmentioning

confidence: 99%

See 1 more Smart Citation

Critical Appraisal of Large Vitamin D Randomized Controlled Trials

et al. 2022

View full text Add to dashboard Cite

As a consequence of epidemiological studies showing significant associations of vitamin D deficiency with a variety of adverse extra-skeletal clinical outcomes including cardiovascular diseases, cancer, and mortality, large vitamin D randomized controlled trials (RCTs) have been designed and conducted over the last few years. The vast majority of these trials did not restrict their study populations to individuals with vitamin D deficiency, and some even allowed moderate vitamin D supplementation in the placebo groups. In these RCTs, there were no significant effects on the primary outcomes, including cancer, cardiovascular events, and mortality, but explorative outcome analyses and meta-analyses revealed indications for potential benefits such as reductions in cancer mortality or acute respiratory infections. Importantly, data from RCTs with relatively high doses of vitamin D supplementation did, by the vast majority, not show significant safety issues, except for trials in critically or severely ill patients or in those using very high intermittent vitamin D doses. The recent large vitamin D RCTs did not challenge the beneficial effects of vitamin D regarding rickets and osteomalacia, that therefore continue to provide the scientific basis for nutritional vitamin D guidelines and recommendations. There remains a great need to evaluate the effects of vitamin D treatment in populations with vitamin D deficiency or certain characteristics suggesting a high sensitivity to treatment. Outcomes and limitations of recently published large vitamin D RCTs must inform the design of future vitamin D or nutrition trials that should use more personalized approaches.

show abstract

Comparisons of different vitamin D supplementation for prevention of osteoporotic fractures: a Bayesian network meta-analysis and meta-regression of randomised controlled trials

Cited by 15 publications

References 33 publications

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

The relationship between healthy lifestyles and bone health

Critical Appraisal of Large Vitamin D Randomized Controlled Trials

Contact Info

Product

Resources

About