Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials

Objective Inconsistent findings in regard to association between different concentrations of vitamin D, calcium or their combination and the risk of fracture have been reported during the past decade in community-dwelling older people. This study was designed to compare the fracture risk using diffe...

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Main Authors: Zhi-Chao Hu, Zhen-Hua Feng, Jiang-Wei Xuan, Wen-Fei Ni, Li Tang, Qian Tang, Chang-Min Sang, Xiaobin Li, Zhi-Hao Shen, Li-Yan Shen, Ai-Min Wu
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e024595.full
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author Zhi-Chao Hu
Zhen-Hua Feng
Jiang-Wei Xuan
Wen-Fei Ni
Li Tang
Qian Tang
Chang-Min Sang
Xiaobin Li
Zhi-Hao Shen
Li-Yan Shen
Ai-Min Wu
author_facet Zhi-Chao Hu
Zhen-Hua Feng
Jiang-Wei Xuan
Wen-Fei Ni
Li Tang
Qian Tang
Chang-Min Sang
Xiaobin Li
Zhi-Hao Shen
Li-Yan Shen
Ai-Min Wu
author_sort Zhi-Chao Hu
collection DOAJ
description Objective Inconsistent findings in regard to association between different concentrations of vitamin D, calcium or their combination and the risk of fracture have been reported during the past decade in community-dwelling older people. This study was designed to compare the fracture risk using different concentrations of vitamin D, calcium or their combination.Design A systematic review and network meta-analysis.Data sources Randomised controlled trials in PubMed, Cochrane library and Embase databases were systematically searched from the inception dates to 31 December 2017.Outcomes Total fracture was defined as the primary outcome. Secondary outcomes were hip fracture and vertebral fracture. Due to the consistency of the original studies, a consistency model was adopted.Results A total of 25 randomised controlled trials involving 43 510 participants fulfilled the inclusion criteria. There was no evidence that the risk of total fracture was reduced using different concentrations of vitamin D, calcium or their combination compared with placebo or no treatment. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of hip or vertebral fractures.Conclusions The use of supplements that included calcium, vitamin D or both was not found to be better than placebo or no treatment in terms of risk of fractures among community-dwelling older adults. It means the routine use of these supplements in community-dwelling older people should be treated more carefully.PROSPERO registration number CRD42017079624.
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spelling doaj-art-99e79937707b4da7a0b09e1cfc9731d52024-12-13T20:50:10ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2018-024595Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trialsZhi-Chao Hu0Zhen-Hua Feng1Jiang-Wei Xuan2Wen-Fei Ni3Li Tang4Qian Tang5Chang-Min Sang6Xiaobin Li7Zhi-Hao Shen8Li-Yan Shen9Ai-Min Wu102 Department of the Second School of Medicine, Wenzhou Medical University, Wenzhou, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China2 Department of the Second School of Medicine, Wenzhou Medical University, Wenzhou, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China3 Department of Bone Research Institute, The Key Orthopaedic Laboratory of Zhejiang Province, Wenzhou, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China4 Department of Orthopaedics, The Affiliated Hospital of Jiujiang Medical College, Jiujiang, China3 Department of Neurology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China1 Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaObjective Inconsistent findings in regard to association between different concentrations of vitamin D, calcium or their combination and the risk of fracture have been reported during the past decade in community-dwelling older people. This study was designed to compare the fracture risk using different concentrations of vitamin D, calcium or their combination.Design A systematic review and network meta-analysis.Data sources Randomised controlled trials in PubMed, Cochrane library and Embase databases were systematically searched from the inception dates to 31 December 2017.Outcomes Total fracture was defined as the primary outcome. Secondary outcomes were hip fracture and vertebral fracture. Due to the consistency of the original studies, a consistency model was adopted.Results A total of 25 randomised controlled trials involving 43 510 participants fulfilled the inclusion criteria. There was no evidence that the risk of total fracture was reduced using different concentrations of vitamin D, calcium or their combination compared with placebo or no treatment. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of hip or vertebral fractures.Conclusions The use of supplements that included calcium, vitamin D or both was not found to be better than placebo or no treatment in terms of risk of fractures among community-dwelling older adults. It means the routine use of these supplements in community-dwelling older people should be treated more carefully.PROSPERO registration number CRD42017079624.https://bmjopen.bmj.com/content/9/10/e024595.full
spellingShingle Zhi-Chao Hu
Zhen-Hua Feng
Jiang-Wei Xuan
Wen-Fei Ni
Li Tang
Qian Tang
Chang-Min Sang
Xiaobin Li
Zhi-Hao Shen
Li-Yan Shen
Ai-Min Wu
Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
BMJ Open
title Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
title_full Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
title_fullStr Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
title_full_unstemmed Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
title_short Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
title_sort comparison of fracture risk using different supplemental doses of vitamin d calcium or their combination a network meta analysis of randomised controlled trials
url https://bmjopen.bmj.com/content/9/10/e024595.full
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