title: Calcium plus vitamin D supplementation and joint symptoms in postmenopausal women in the women's health initiative randomized trial.
abstract: BACKGROUND
  Low vitamin D intake and levels have been associated with increased joint symptoms in some observational studies but the findings are mixed and evidence from randomized trials sparse.
  
  
  OBJECTIVE
  To evaluate the influence of supplemental calcium and vitamin D on joint symptoms in the Women's Health Initiative randomized, placebo-controlled, clinical trial.
  
  
  METHODS
  In post hoc analyses, the results of the Women's Health Initiative randomized clinical trial in which 36,282 postmenopausal women were randomized to receive calcium carbonate (1,000 mg as elemental calcium) with vitamin D-3 (400 IU) daily or placebo were examined in the 6% subgroup of 1,911 participants, oversampled for minorities, who had serial joint symptom assessment. Qualitative information on joint pain and joint swelling was collected by questionnaire before entry and 2 years after randomization. Logistic regression models were used to compare the occurrence and severity of joint symptoms across randomization groups.
  
  
  RESULTS
  At baseline, total calcium and vitamin D intakes from diet and supplements were similar in the two randomization groups. In addition, both joint pain (reported by 73%) and joint swelling (reported by 34%) were commonly reported and comparable in the supplement and placebo groups. Two years after randomization, no statistically significant differences between supplement and placebo groups were seen for joint pain frequency (74.6% compared with 75.1% [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency (34.6% compared with 32.4% [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses suggested study participants also using nonprotocol calcium supplements at study entry may have less joint pain with supplement group randomization (interaction P=0.02).
  
  
  CONCLUSIONS
  Joint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1,000 mg calcium carbonate and 400 IU vitamin D-3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms.
authors: Rowan T
authors: RT
authors: Chlebowski
authors: Mary
authors: M
authors: Pettinger
authors: Karen C
authors: KC
authors: Johnson
authors: Robert
authors: R
authors: Wallace
authors: Catherine
authors: C
authors: Womack
authors: Yasmin
authors: Y
authors: Mossavar-Rahmani
authors: Marcia
authors: M
authors: Stefanick
authors: Jean
authors: J
authors: Wactawski-Wende
authors: Laura
authors: L
authors: Carbone
authors: Bing
authors: B
authors: Lu
authors: Charles
authors: C
authors: Eaton
authors: Brian
authors: B
authors: Walitt
authors: Charles L
authors: CL
authors: Kooperberg
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000188:drug therapy*; D002119:Calcium Carbonate / Q000008:administration & dosage; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002762:Cholecalciferol / Q000008:administration & dosage*; D004032:Diet; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D016387:Women's Health
chemical_list: D002136:Calcium, Dietary; D002762:Cholecalciferol; D002119:Calcium Carbonate
keywords: Calcium; Joint symptoms; Vitamin D
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