Vitamin D and Health

Adults (50 years and above)
Table 19: Meta-analysis of RCTs on effects of vitamin D supplementation on bone health indices in adults ≥ 50y
Study Methods Results Conclusions
Reid et al (2014)
Effects of vitamin D
supplements on bone
mineral density: a
systematic review and
meta-analysis
Selection criteria:
Inclusion: RCTs comparing interventions that differed
only in vitamin D content; in adults aged > 20 y;
intervention with vitamin D2 and D3 but not vitamin
D metabolite. Any other intervention (e.g. calcium)
had to be same in all groups.
Exclusion: studies of individuals with other disorders
likely to affect bone and calcium metabolism.
Outcome measure: BMD
23 trials (n=4082, mean age 59y, mean duration 23.5 months)
Mean 25(OH)D < 30 nmol/L in 5 studies, 30–50 nmol/L in 3 studies, 50–75 nmol/L
in 11 studies, and > 75 nmol/L in 1 study.
Ca supplements administered to all participants in 12 trials.
Weighted mean difference (%) (95% CI) in BMD
Lumbar spine (17 RCTs): 0.0 (-0.2 to 0.3); p = 0.8
Femoral neck (13 RCTs): 0.8 (0.2 to 1.4); (p=0.005)
Hip/trochanter (15 RCTs): 0.2 (-0.1 to 0.4); (p=0.17)
Total body (8 RCTs): -0.3 (-0.7 to 0.1); (p=0.2)
Forearm (6 RCTs): -0.3 (-0.7 to 0.1); (p=0.09)
Small benefit at femoral
neck but no effect at any
other site.
Table 20: RCTs (not included in above meta-analysis) on effect of vitamin D supplementation on bone health indices in adults ≥ 50y
Study/country Population Intervention & Duration Mean baseline
25(OH)D (nmol/L)
Karkkaiinen et al
(2010)
Kuopio, Finland
Macdonald et al
(2013)
Aberdeen,
Scotland
Postmenopausal women
(n=593)
Mean age: 67.4 (2) y
Healthy postmenopausal
women (n=305)
Mean age 64.6 (2.3)
1. 20 µg/d vitamin D & 1000
mg Ca
2. Placebo
Duration: 3 y
1. 10 µg/d D3
2. 25 µg/d D3
3. Placebo
Duration: 1 year
1. 50.1 (± 18.8)
2. 49.2 (± 17.7)
1. 33.4 ± 13.2l
2. 33.2 ± 13.8l
3. 35.8 ± 16.4
Mean post intervention
25(OH)D (nmol/L)
1. 74.6 (± 21.9)
2. 2. 55.9 (± 21.8)
1. 65.0 ± 19.7
2. 75.9 ± 18.9
3. 32.0 ± 14.9
Results
Significant increase in total body BMD in vit D
groupp than in control group (-2.69% vs -2.83%;
p=0.03).
No difference between groups in BMD changes at
spine, femoral neck, trochanter & total proximal
femur.
Mean BMD loss at hip significantly less for 25 µg/d
vit D group (-0.05%±1.46%) compared with
10 µg/d vit D group (-0.57%±1.33) or placebo
group (-0.60%±1.66).
BMD change at lumbar spine not significantly
different between groups.
Table 21: Cohort studies on association between 25(OH)D concentration and bone health indices in adults ≥ 50y
Study/Country Population Follow-up Mean 25(OH)D (nmol/L) Results
Ensrud et al (2009)
Community dwelling men (n=1279)
Age: 65y +
4.4y 59.4
Median: 63.4 (50.9-75.1)
Lower 25(OH)D associated with higher rates of bone loss at total hip (ptrend=0.01).
Majority of effect observed among men in lowest quintile (< 47.7 nmol/L) who
experienced 1.5-fold higher rate of hip bone loss (p=0.003 for Q1 vs Qs 2-5).
In men ≥ 75y, lower 25(OH)D associated with higher rates of hip bone loss (p trend