Two regimens , each represented by one large trial , which showed limited evidence of efficacy in reducing the incidence of hip or other appendicular skeleton fractures were : 1 ) Oral Vitamin D when accompanied by calcium supplementation .
2 ) 1,25 dihydroxy Vitamin D ( calcitriol ) .
This appeared more effective than calcium in a direct comparison .
Hypercalcaemia and gastro-intestinal symptoms , reported in less than 5 % of participants , were slightly more common when Vitamin D analogues were taken .
However , the risk of death was marginally less .
REVIEW ER 'S CONCLUSIONS Uncertainty remains about the efficacy of regimens which include Vitamin D or its analogues in fracture prevention .
Particularly if co-supplementation of calcium is required , significant cost differences are likely to exist between regimens .
BACKGROUND Due to their known effects on bone metabolism , Vitamin D and related compounds have been proposed for the prevention of osteoporosis and fractures .
OBJECTIVES To determine the effects of supplementation with Vitamin D or a Vitamin D analogue in the prevention of fractures of the axial and appendicular skeleton in elderly men or women with involutional or post-menopausal osteoporosis .
Comparison of methods for defining prevalent vertebral deformities: the Study of Osteoporotic Fractures.
Women with vertebral deformities caused by osteoporosis have more back pain and disability and are at higher risk for subsequent vertebral deformities than women without deformities . Despite the importance of vertebral deformities , there has been a great deal of controversy about how to identify or define them . In order to compare methods for defining vertebral deformities , we studied  spinal radiographs from women in the Study of Osteoporotic Fractures ( SOF ) , a cohort study of 9704 non-black women over age 65 recruited from population -based listings in four clinical centers . Using radiographs obtained at the baseline exam , we compared five methods for defining vertebral deformities : one based on a semiquantitative reading by a radiologist and four using vertebral morphometry . The semiquantitative method was compared with the other methods in a r and om sample of 503 films , while the morphometric methods were compared with each other in a larger sample of 9575 films . We tested a system of " triage " in which only those films with evidence of deformity were assessed by morphometry . We compared the relationship between deformity , defined by each method , and a variety of clinical criteria including bone mineral density at the lumbar spine , height loss since age 25 , back pain , and incidence of subsequent deformity . Semiquantitative reading and three of the four morphometry-based methods provided similar relationships to clinical criteria . The fourth morphometry method ( based on ratios of each vertebral height to the corresponding height at T4 ) produced significantly weaker relationships for several of the clinical validation criteria . Triage of radiographs rarely result ed in missed deformities and did not reduce the performance of any of the methods . We conclude that use of any of the similar methods , with or without triage , provides a valid approach to defining vertebral deformities
Two regimens , each represented by one large trial , which showed limited evidence of efficacy in reducing the incidence of hip or other appendicular skeleton fractures were : 1 ) Oral Vitamin D when accompanied by calcium supplementation .
2 ) 1,25 dihydroxy Vitamin D ( calcitriol ) .
This appeared more effective than calcium in a direct comparison .
Hypercalcaemia and gastro-intestinal symptoms , reported in less than 5 % of participants , were slightly more common when Vitamin D analogues were taken .
However , the risk of death was marginally less .
REVIEW ER 'S CONCLUSIONS Uncertainty remains about the efficacy of regimens which include Vitamin D or its analogues in fracture prevention .
Particularly if co-supplementation of calcium is required , significant cost differences are likely to exist between regimens .
BACKGROUND Due to their known effects on bone metabolism , Vitamin D and related compounds have been proposed for the prevention of osteoporosis and fractures .
OBJECTIVES To determine the effects of supplementation with Vitamin D or a Vitamin D analogue in the prevention of fractures of the axial and appendicular skeleton in elderly men or women with involutional or post-menopausal osteoporosis .