Vitamin D Supplementation Alone May Not Reduce Fracture Risk

Supplementation with vitamin D alone does not appear to reduce the risk for fracture, according to a review published online in JAMA Network Open.

Pang Yao, Ph.D., from the University of Oxford in the United Kingdom, and colleagues conducted a systematic review to examine the risks for fracture associated with differences in concentrations of 25-hydroxyvitamin D (25[OH]D) in observational studies and fracture risks associated with vitamin D supplementation alone or in combination with calcium in randomized clinical trials (RCTs).

The researchers found that each 10.0-ng/mL increase in 25(OH)D concentration correlated with an adjusted rate ratio (RR) of 0.93 for any fracture and 0.80 for hip fracture based on a meta-analysis of 11 observational studies with 39,141 participants. There was no significantly reduced risk for any fracture or hip fracture in a meta-analysis of 11 RCTs (34,243 participants) of vitamin D supplementation alone (daily or intermittent dose of 400 to 30,000 IU); infrequent intermittent dosing, low daily doses of vitamin D, or an inadequate number of participants constrained these trials. Combined supplementation with vitamin D (daily doses of 400 to 800 IU) and calcium resulted in a reduced risk for any fracture (RR, 0.94) and hip fracture (RR, 0.84) based on a meta-analysis of six RCTs (49,282 participants).

"Further RCTs are needed to assess the efficacy and safety of higher daily doses of vitamin D with calcium in high-risk individuals for prevention of fracture," the authors write.

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