Calcium plus vitamin D supplementation has limited effects on femoral geometric strength in older postmenopausal women: the Women's Health Initiative.
Calcium plus vitamin D (CaD) supplementation has a modest but significant effect on slowing loss of femoral bone mass and reducing risk of hip fractures in adherent postmenopausal women. The goal of this study was to determine if CaD supplementation influences hip structural parameters that are associated with fracture risk. We studied 1,970 postmenopausal women enrolled in the Women's Health Initiative randomized controlled trial of CaD at one of three bone mineral density (BMD) clinical centers. Hip structural analysis software measured BMD and strength parameters on DXA scans at three regions: femoral narrow neck, intertrochanter, and shaft. Random effects models were used to test the average differences in hip BMD and geometry between intervention and placebo. There was greater preservation of hip BMD at the narrow neck with CaD relative to placebo across 6 years of intervention. CaD also altered the underlying cross-sectional geometry at the narrow neck in the direction of greater strength, with small increases in cross-sectional area and section modulus and a decrease in buckling ratio with CaD relative to placebo. While trends at both the intertrochanter and shaft regions were similar to those noted at the narrow neck, no significant intervention effects were evident. There was no significant interaction of CaD and age or baseline calcium levels for hip structural properties. CaD supplementation is associated with modest beneficial effects on hip structural features at the narrow neck, which may explain some of the benefit of CaD in reducing hip fracture risk.
College of Medicine, Division of Endocrinology, Diabetes and Metabolism, Center for Clinical and Translational Science, The Ohio State University, Columbus, 43210, USA. jackson.20@osu.edu
Rebecca D
RD
Jackson
Nicole C
NC
Wright
Thomas J
TJ
Beck
Duane
D
Sherrill
Jane A
JA
Cauley
Cora E
CE
Lewis
Andrea Z
AZ
LaCroix
Meryl S
MS
LeBoff
Scott
S
Going
Tamsen
T
Bassford
Zhao
Z
Chen
D000368:Aged; D001824:Body Constitution / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000008:administration & dosage* / Q000494:pharmacology; D019245:Compressive Strength / Q000187:drug effects; D019587:Dietary Supplements; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology / Q000517:prevention & control*; D010919:Placebos; D017698:Postmenopause / Q000187:drug effects*; D014807:Vitamin D / Q000008:administration & dosage* / Q000494:pharmacology; D016387:Women's Health
D004338:Drug Combinations; D010919:Placebos; D014807:Vitamin D; D002118:Calcium
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