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Kazemian E, Pourali A, Sedaghat F, Karimi M, Basirat V, Sajadi Hezaveh Z, Davoodi SH, Holick MF. Effect of supplemental vitamin D3 on bone mineral density: a systematic review and meta-analysis. Nutr Rev 2022; 81:511-530. [PMID: 36308775 DOI: 10.1093/nutrit/nuac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Context
There is still controversy over the effect of vitamin D3 supplementation on bone health.
Objective
The effects of vitamin D3 supplementation on bone mineral density (BMD) and markers of bone turnover, as well as the dose-response relationship between vitamin D3 and bone health in adults, were evaluated.
Data Sources
The PubMed, Scopus, Cochrane, Web of Science, and AGRIS databases were searched for articles published through April 30, 2022. Thirty-nine of the 6409 records identified met the inclusion criteria
Data Extraction
Data were extracted from articles by 2 authors, and data extraction was cross-checked independently. A random-effects model was used to estimate the pooled effect size and the associated 95%CI for the effect of vitamin D3 for each outcome. A one-stage random-effects dose-response model was used to estimate the dose-response relationship between vitamin D3 supplementation and BMD.
Data Analysis
Results of meta-analysis showed a beneficial effect of vitamin D3 at the lumbar spine (standardized mean difference [SMD] = 0.06; 95%CI, 0.01–0.12) and femoral neck (SMD = 0.25; 95%CI, 0.09–0.41). Dose-response analysis revealed a linear relationship between vitamin D3 supplementation doses and BMD at the femoral neck, lumbar spine, and total hip sites. No significant effect of vitamin D3 supplementation on whole-body or total hip BMD was observed (P > 0.05). Vitamin D3 supplementation significantly decreased BMD at both proximal and distal forearm (SMD = −0.16; 95%CI, −0.26 to −0.06). The variables of ethnicity, age, baseline 25-hydroxyvitamin D (25[OH]D), menopause status, vitamin D3 dosing frequency, and bone health status (P interaction = 0.02) altered the effect of vitamin D3 supplementation on BMD. Additionally, a nonlinear relationship between vitamin D3 supplement doses and markers of bone turnover was found.
Conclusion
A protective effect of vitamin D3 supplementation on BMD of the lumbar spine, femoral neck, and total hip is implicated.
Systematic Review Registration
PROSPERO registration number CRD42017054132.
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Affiliation(s)
- Elham Kazemian
- Alborz University of Medical Sciences Non-Communicable Diseases Research Center, , Karaj, Iran
| | - Ali Pourali
- Mazandaran University of Medical Sciences Faculty of Medicine, , Sari, Iran
| | - Fatemeh Sedaghat
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Department of Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology, , Tehran, Iran
| | - Mehrdad Karimi
- Department of Public Health, Khoy University of Medical Sciences , Khoy, West Azerbaijan, Iran
| | - Vahid Basirat
- Isfahan University of Medical Sciences and Health Services Department of Gastroenterology, School of Medicine, , Isfahan, Iran
| | - Zohreh Sajadi Hezaveh
- Shahid Beheshti University of Medical Sciences Cancer Research Center, , Tehran, Iran
- National Nutrition and Food Technology Research Institute Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, , Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Hossein Davoodi
- National Nutrition and Food Technology Research Institute Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, , Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael F Holick
- is with the Section of Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine , Boston, Massachusetts, USA
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Quality of life and patient satisfaction with raloxifene/cholecalciferol combination therapy in postmenopausal women. Sci Rep 2022; 12:7142. [PMID: 35505063 PMCID: PMC9065022 DOI: 10.1038/s41598-022-11298-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/18/2022] [Indexed: 11/08/2022] Open
Abstract
This study was performed to evaluate quality of life (QOL) and patient satisfaction with raloxifene/cholecalciferol combination therapy in postmenopausal women with low bone mass. This multicenter, prospective, noninterventional observational study included 3907 postmenopausal women who received a combination of raloxifene 60 mg and cholecalciferol 800 IU daily to treat or prevent osteoporosis. Changes in QOL and patient satisfaction were evaluated after 3 and 6 months of treatment. In addition, the safety profile was assessed. Mean age was 67.7 ± 9.3 years old. QOL, assessed by European Quality of life instrument 5 Dimensions (EQ-5D) index, improved significantly after 3 months (0.81 ± 0.11, P < 0.001) and 6 months (0.82 ± 0.11, P < 0.001) of treatment compared to the baseline (0.78 ± 0.14). Improvement in QOL was also significant regardless of previous regimens both in women who were switched from other drugs (bisphosphonates or selective estrogen receptor modulators) and in women who received the study drug for the first time (P < 0.001 for all comparisons). Percentage of women satisfied with the effects (from 37.3 to 67.7%, P < 0.001) and convenience (from 42.8 to 74.1%, P < 0.001) of treatment compared to previous medication significantly increased after 6 months of treatment. In addition, serious adverse drug reactions did not occur, and hot flushes were observed only in 12 women (0.3%). Combination therapy with raloxifene and cholecalciferol significantly improves quality of life with no serious adverse events and high patient satisfaction at 6 months. Our real-world data suggest that this regimen is a promising option for postmenopausal women with low bone mass.
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Park CW, Lim SJ, Moon YW, Choi SH, Shin MH, Min YK, Yoon BK, Park YS. Fracture recurrence in hip fracture with menopausal hormone therapy versus risedronate: a clinical trial. Climacteric 2021; 24:408-414. [PMID: 34240673 DOI: 10.1080/13697137.2021.1915271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES An open-label, randomized trial was conducted to examine the effects of risedronate versus menopausal hormone therapy (MHT) in postmenopausal women with recent hip fracture. METHODS Among 1165 eligible women, 281 were recruited and randomly assigned to receive oral risedronate (35 mg/week) or percutaneous estradiol gel (1.5 mg/day) plus oral micronized progesterone (100 mg/day) for 4 years. The primary end point was recurrent fracture and the secondary end points were mortality and bone mineral density (BMD). RESULTS Kaplan-Meier analyses showed no significant differences in fracture recurrence and mortality between the two groups. The incidence of any new fracture per 100 person-years (PY) was 8.63 in the risedronate group and 12.86 in the MHT group (p = 0.180); that of clinical fracture was 4.75 and 6.99, respectively (p = 0.265); and that of asymptomatic vertebral fracture was 4.87 and 5.58, respectively (p = 0.764). The respective incidence of death per 100 PY was 3.58 and 4.40 (p = 0.503). BMD increased comparably at the lumbar spine in both groups. BMD at the total hip did not change in the risedronate group, but increased significantly by 2.8% in the MHT group. CONCLUSIONS MHT might not differ from risedronate in the prevention of secondary fractures and death among postmenopausal women with recent hip fracture.
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Affiliation(s)
- C-W Park
- Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S-J Lim
- Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-W Moon
- Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S-H Choi
- Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M-H Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-K Min
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-K Yoon
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-S Park
- Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
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