For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .
Cholecalciferol Additively Reduces Serum Parathyroid Hormone Levels in Severe Secondary Hyperparathyroidism Treated with Calcitriol and Cinacalcet among Hemodialysis Patients
We evaluated the improvement of intact parathyroid hormone ( iPTH ) levels and bone parameters by supplementing nutritional vitamin D ( cholecalciferol ) to combined calcimimetic ( cinacalcet ) and active vitamin D analog ( calcitriol ) among severe secondary hyperparathyroidism ( SHPT ) hemodialysis ( HD ) patients . A r and omized , controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after > 3 months of calcitriol ( 3 μg/week ) . The study group received oral cholecalciferol ( 5000 IU/ day ) and the control group received a placebo . All patients received fixed dose cinacalcet ( 30 mg/day , orally ) and calcitriol . Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low ( iPTH ≤ 300 pg/mL ) for 4 weeks after the reduction of calcitriol . A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group , and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group . Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group . Nearly 40 % of study patients gained > 10 % improvement in femoral neck ( FN ) bone mineral density ( BMD ) . We conclude that cholecalciferol additively reduced serum iPTH levels , improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients
For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .