Effect of Calcium or 25OH Vitamin D3 Dietary Supplementation on Bone Loss at the Hip in Men and Women over the Age of 601
Munro Peacock,
Guangda Liu,
Mark Carey,
Ronald McClintock,
Walter Ambrosius,
Siu Hui and
C. Conrad Johnston
Department of Medicine, Indiana University School of Medicine,
Indianapolis, Indiana 46202
Address correspondence and requests for reprints to: Munro Peacock, M.D., General Clinical Research Center, University Hospital and Outpatient Center, Room 5595, 550 North University Boulevard, Indianapolis, Indiana 46202.
Dietary supplements that prevent bone loss at the hip and thatcan be
applied safely in the elderly are likely to reduce hipfractures. A
daily dietary supplement of 750 mg calcium or 15µg 25OH vitamin
D3 on bone loss at the hip and other sites,bone turnover
and calcium-regulating hormones were studied over4 yr in elderly
volunteers using a randomized, double-blind,placebo-controlled trial.
Bone mineral density (BMD) was measuredby dual x-ray absorptiometry
and bone structure by radiographs.Calcium biochemistry and bone
turnover markers were measuredin blood and urine. The 316 women
entering the trial had a meanage of 73.7 yr and the 122 men of 75.9
yr. Baseline median calciumintake was 546 mg/day, and median serum
25OH vitamin D3 was59 nmol/L. On placebo, loss of BMD at
total hip was 2% and femoralmedulla expansion was 3% over 4 yr.
Calcium reduced bone loss,secondary hyperparathyroidism, and bone
turnover. 25OH vitaminD3 was intermediate between placebo
and calcium. Fracture ratesand drop-out rates were similar among
groups, and there wereno serious adverse events with either
supplement. A calciumsupplement of 750 mg/day prevents loss of BMD,
reduces femoralmedullary expansion, secondary hyperparathyroidism, and
highbone turnover. A supplement of 15 µg/day 25OH vitamin
D3is less effective, and because its effects are seen only
atlow calcium intakes, suggests that its beneficial effect isto
reverse calcium insufficiency.
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