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 .
A Controlled Study of Vitamin D3 to Prevent Bone Loss in Renal-Transplant Patients Receiving Low Doses of Steroids
Background . New and potent immunosuppressive regimens allow for reduced doses of corticosteroids after renal transplantation . The aims of our study were to investigate whether the use of low-dose corticosteroids is associated with a reduction in posttransplant bone loss and to assess the ability of cholecalciferol supplementation to further decrease bone loss in this setting . Methods . Ninety patients admitted for renal transplantation and scheduled to be treated per protocol with low doses of prednisolone  were r and omized to receive either 400 mg daily oral calcium ( Ca group , n=44 ) or the same dose of calcium in association with a monthly dose of 25,000 IU of vitamin D3 ( CaVitD group , n=46 ) . Bone mineral density ( BMD ) was measured by dual energy absorptiometry at baseline and at 1 year . Results . The overall population experienced a moderate but significant −2.3±0.9 % loss of lumbar spine BMD ( P<0.01 ) but no bone loss at the femoral neck and shaft during the first posttransplant year . Bone loss tended to be slightly higher in the CaVitD group , but the difference did not reach statistical significance . Patients in the CaVitD group had significantly higher 25(OH ) but not 1,25(OH)2 vitamin D levels . We observed a highly significant negative correlation between 25(OH ) vitamin D and intact parathyroid hormone ( iPTH ) serum levels . Conclusions . Kidney-transplant recipients receiving modern immunosuppressive regimens with low doses of corticosteroids experience only minimal loss of BMD during the first posttransplant year . Cholecalciferol supplementation did not prevent posttransplant bone loss but contributed to the normalization of iPTH levels after renal transplantation
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 .