title: Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss.
abstract: OBJECTIVE
  To determine whether augmentation of dietary calcium is effective in the prevention of early postmenopausal bone loss.
  
  
  METHODS
  Three-arm, placebo-controlled, randomized parallel trial. The study duration was 2.9 +/- 1.1 (SD) years.
  
  
  METHODS
  General community.
  
  
  METHODS
  118 healthy, white women 3 to 6 years after spontaneous menopause, recruited by community announcement.
  
  
  METHODS
  Random allocation to daily intake of 1700 mg of calcium (calcium carbonate given in divided doses with meals); placebo; or conjugated equine estrogens (0.625 mg; days 1 to 25), progesterone (10 mg; days 16 to 25), and 1700 mg of elemental calcium daily. Each participant  received 400 IU of vitamin D daily.
  
  
  METHODS
  Total body calcium measured by delayed gamma neutron activation  analysis and whole-body counting; bone mineral density of the spine, femur, and radius measured by photon absorptiometry.
  
  
  RESULTS
  Bone mineral density declined in the placebo group for the lumbar spine (-2.1%/y; 95% Cl, -3.3 to -0.9), femoral neck (-2.0%/y; Cl, -2.6 to -1.2), trochanter (-1.6%/y; Cl, -2.4 to -0.8), Ward triangle (-2.7%/y; Cl, -3.7 to -1.7), and total body calcium (-2.0%/y; Cl, -2.2 to -1.8). Rates of change were intermediate for calcium augmentation compared with placebo and estrogen-progesterone-calcium but statistically significant compared with placebo for total body calcium (-0.5%/y; Cl, -0.9 to -0.1; P = 0.006) and the femoral neck (-0.8%/y; Cl, -1.4 to -0.2; P = 0.03).
  
  
  CONCLUSIONS
  Although less effective than estrogen-progesterone-calcium, calcium augmentation alone significantly retards bone loss from the femoral neck and improves calcium balance in recently postmenopausal women. Dietary calcium augmentation should be recommended as a strategic option in helping to prevent early postmenopausal bone loss.
authors.affiliation: Department of Medicine, Winthrop-University Hospital, Mineola, NY 11501.
authors.forename: J F
authors.initials: JF
authors.lastname: Aloia
authors.forename: A
authors.initials: A
authors.lastname: Vaswani
authors.forename: J K
authors.initials: JK
authors.lastname: Yeh
authors.forename: P L
authors.initials: PL
authors.lastname: Ross
authors.forename: E
authors.initials: E
authors.lastname: Flaster
authors.forename: F A
authors.initials: FA
authors.lastname: Dilmanian
mesh_terms: D000704:Analysis of Variance; D015519:Bone Density; D002119:Calcium Carbonate / Q000032:analysis / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000032:analysis / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000378:metabolism / Q000517:prevention & control*; D011374:Progesterone / Q000627:therapeutic use
chemical_list: D002136:Calcium, Dietary; D004966:Estrogens, Conjugated (USP); D011374:Progesterone; D002119:Calcium Carbonate