Does supplementation with calcium alone or in combination with vitamin D reduce the risk of osteoporotic fracture?  

Oleh:

Becker, Carolyn B

Jenis: Article from Bulletin/Magazine - ilmiah internasional
Dalam koleksi: Medical Progress vol. 35 no. 08 (Aug. 2008), page 369.

Ketersediaan

Perpustakaan FK Nomor Panggil: M36.K.2008.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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background: osteoporosis has become a key public-health issue; however, preventative theraphy with pharmacological agents can be expensive. Investigating the efficacy of cheaper, alternative therapeutic agents is clearly a priority. Objective: to assess the efficacy of supplementation with calcium alone or calcium in combination with vitamin D for prevention of osteoporotic fracture. design and intervention: this was a meta-analysis of randomized controlled trials that reported on fractures and/or BMD as a main outcome measure. Studies were excluded if they enroll partisipants< 50 years old, didnot include a placebo or control group, used calcium supplementation as part of a complex nutritional program, used calcium in combination with other anti-osteoporosis agents, enrooled patient with secondary osteoporosis, or used vit D alone. outcome Measures: the primary outcome measure was fracture at any site. the secondary outcome measure was the percentage change in BMD from baseline. Result: the meta-analysis included 29 studies (a total of 63,897 individuals). the mean age was 67.8 years, 92% of the participants were women, and the median fracture risk at baseline was 16%. Participants received calcium in combination with vitamin D in 13 studies. fracture was the only outcome measure assessed in 5 of the studies, where as 12 studies assessed only BMD and 12 studies assessed both fracture and BMD. in the 17 trials that reported on fracture, treatment with calcium alone and in combination with vit D was associated with a 12 % reduction in the risk of all the types of fracture. in the 24 trials that reported on BMD, treatment with calcium alone or in combination with vit D was associated with reduced bone loss at the hip. bone loss in the spine was also reduced by treatment. A compliance rate of >- 80% was associatede with a 24 % risk reduction in fractures at all site and a RR of 0.76. the treatment effect of calcium supplementation was not affected by inclusion of vit D in the regimen, history of previous fracture, fracture site, or sex. by contrast, the treatment effect was enchanced in participants who were institutionalized; in participants with a low daily calcium intake; at calcium doses>=1,200 mg daily; at vit D doses>=800 IU daily; and in participants aged >= 70 years. conclusion: the result of the meta-analysis support the use of calcium supplementation alone or in combination with vit D

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