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Vitamin D3and Calcium to Prevent Hip Fractures in Elderly Women

Open access
Chapuy, Marie C., Arlot, Monique E., Duboeuf, François, Brun, Jacqueline, Crouzet, Brigitte, Arnaud, Simone, Delmas, Pierre D., Meunier, Pierre J.·1992·New England Journal of Medicine
DOI 10.1056/nejm199212033272305
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Abstract

BACKGROUND: Hypovitaminosis D and a low calcium intake contribute to increased parathyroid function in elderly persons. Calcium and vitamin D supplements reduce this secondary hyperparathyroidism, but whether such supplements reduce the risk of hip fractures among elderly people is not known. METHODS: We studied the effects of supplementation with vitamin D3 (cholecalciferol) and calcium on the frequency of hip fractures and other nonvertebral fractures, identified radiologically, in 3270 healthy ambulatory women (mean [+/- SD] age, 84 +/- 6 years). Each day for 18 months, 1634 women received tricalcium phosphate (containing 1.2 g of elemental calcium) and 20 micrograms (800 IU) of vitamin D3, and 1636 women received a double placebo. We measured serial serum parathyroid hormone and 25-hydroxyvitamin D (25(OH)D) concentrations in 142 women and determined the femoral bone mineral density at base line and after 18 months in 56 women. RESULTS: Among the women who completed the 18-month study, the number of hip fractures was 43 percent lower (P = 0.043) and the total number of nonvertebral fractures was 32 percent lower (P = 0.015) among the women treated with vitamin D3 and calcium than among those who received placebo. The results of analyses according to active treatment and according to intention to treat were similar. In the vitamin D3-calcium group, the mean serum parathyroid hormone concentration had decreased by 44 percent from the base-line value at 18 months (P < 0.001) and the serum 25(OH)D concentration had increased by 162 percent over the base-line value (P < 0.001). The bone density of the proximal femur increased 2.7 percent in the vitamin D3-calcium group and decreased 4.6 percent in the placebo group (P < 0.001). CONCLUSIONS: Supplementation with vitamin D3 and calcium reduces the risk of hip fractures and other nonvertebral fractures among elderly women.

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Authors
Chapuy, M. C., Arlot, M. E., Duboeuf, F., Brun, J., Crouzet, B., Arnaud, S., Delmas, P. D., & Meunier, P. J.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1992-12-03
Volume
327
Issue
23
Pages
1637-1642
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199212033272305
OpenAlex
W2314110838
Cited by
2,950
References
0
FWCI
59.41
Type
journal article
Language
en
Open access
bronze

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