title: Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60.
abstract: Dietary supplements that prevent bone loss at the hip and that can be applied safely in the elderly are likely to reduce hip fractures. A daily dietary supplement of 750 mg calcium or 15 microg 25OH vitamin D3 on bone loss at the hip and other sites, bone turnover and calcium-regulating hormones were studied over 4 yr in elderly volunteers using a randomized, double-blind, placebo-controlled trial. Bone mineral density (BMD) was measured by dual x-ray absorptiometry and bone structure by radiographs. Calcium biochemistry and bone turnover markers were measured in blood and urine. The 316 women entering the trial had a mean age of 73.7 yr and the 122 men of 75.9 yr. Baseline median calcium intake was 546 mg/day, and median serum 25OH vitamin D3 was 59 nmol/L. On placebo, loss of BMD at total hip was 2% and femoral medulla expansion was 3% over 4 yr. Calcium reduced bone loss, secondary hyperparathyroidism, and bone turnover. 25OH vitamin D3 was intermediate between placebo and calcium. Fracture rates and drop-out rates were similar among groups, and there were no serious adverse events with either supplement. A calcium supplement of 750 mg/day prevents loss of BMD, reduces femoral medullary expansion, secondary hyperparathyroidism, and high bone turnover. A supplement of 15 microg/day 25OH vitamin D3 is less effective, and because its effects are seen only at low calcium intakes, suggests that its beneficial effect is to reverse calcium insufficiency.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis 46202, USA.
authors.forename: M
authors.initials: M
authors.lastname: Peacock
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.forename: M
authors.initials: M
authors.lastname: Carey
authors.forename: R
authors.initials: R
authors.lastname: McClintock
authors.forename: W
authors.initials: W
authors.lastname: Ambrosius
authors.forename: S
authors.initials: S
authors.lastname: Hui
authors.forename: C C
authors.initials: CC
authors.lastname: Johnston
mesh_terms: D000368:Aged; D015415:Biomarkers; D015519:Bone Density; D001842:Bone and Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D002112:Calcifediol / Q000097:blood / Q000494:pharmacology*; D002118:Calcium / Q000097:blood / Q000378:metabolism / Q000494:pharmacology*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006615:Hip / Q000502:physiology*; D006728:Hormones / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D011859:Radiography
chemical_list: D015415:Biomarkers; D006728:Hormones; D010281:Parathyroid Hormone; D002112:Calcifediol; D002118:Calcium