ACP Journal Club
16 September 2014

Review: In postmenopausal women and older men, vitamin D plus calcium reduces some fractures

Publication: Annals of Internal Medicine
Volume 161, Number 6

Abstract

Source Citation

Avenell A, Mak JC, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;4:CD000227. https://pubmed.ncbi.nlm.nih.gov/24729336/

Abstract

Clinical Impact Ratings

GIM/FP/GP: 6 out of 7
Geriatrics: 6 out of 7

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Reference

1.
Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155:827-38. [PMID: 22184690]
2.
Moyer VA; U.S. Preventive Services Task Force. Vitamin D and calcium supplementation to prevent fractures in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;158:691-6. [PMID: 23440163]
3.
Mouyis M,Ostor A,Crisp A, et al. Hypovitaminosis D among rheumatology outpatients in clinical practice. Rheumatology 2008;47:1348-51. [PMID: 18499714]

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Gauranga Dhar22 September 2014
Vitamin D should always be combined with calcium to prevent fracture in patients with osteoporosis
Traditionally, we, the clinicians use bisphosphonates along with calcium and vitamin D for the treatment of osteoporosis. All the forms of vitamin D; D2, D3, 25-(OH)-D transform to its’ active form
1,25-OH)2-D3 (calcitriol) for proper action; absorption of calcium from GI tract and renal tubular calcium reabsorption. This transformation happens as long as 1-alpha-hydroxylase enzyme is active in proximal tubules of the kidney. This study supports our current practice that we should continue to use calcium with vitamin D along with bisphosphonate for the treatment of osteoporosis. In case of renal impairment, vitamin-D in the form of calcitriol is indicated to prevent fracture from renal osteodystrophy.
Very good alert is seen in this study that Vitamin-D only is not effective in reducing fracture.

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 161Number 616 September 2014
Pages: JC5

History

Published online: 16 September 2014
Published in issue: 16 September 2014

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Authors

Affiliations

KoKo Aung, MD, MPH
University of Texas Health Science Center, San Antonio, Texas, USA (K.A.)
This article was published at Annals.org on 2 September 2014.

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KoKo Aung. Review: In postmenopausal women and older men, vitamin D plus calcium reduces some fractures. Ann Intern Med.2014;161:JC5. [Epub 16 September 2014]. doi:10.7326/0003-4819-161-6-201409160-02005

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