Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial — Trivedi et al. 326 (7387): 469 — BMJ

BMJ2003;326:469 ( 1 March )

Papers

Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial

Daksha P Trivedi, research fellowa Richard Doll, emeritus professorb Kay Tee Khaw, professor of clinical gerontologya

a Clinical Gerontology Unit, University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge CB2 2QQ, b Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford

Correspondence to: K T Khaw kk101@medschl.cam.ac.uk // <![CDATA[
var u = “kk101”, d = “medschl.cam.ac.uk”; document.getElementById(“em0”).innerHTML = ‘‘ + u + ‘@’ + d + ”
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Objective: To determine the effect of four monthly vitaminD supplementation on the rate of fractures in men and women aged65 years and over living in thecommunity.
Design: Randomised double blind controlled trial of100 000 IU oral vitamin D3 (cholecalciferol) supplementation ormatching placebo every four months over fiveyears.
Setting and participants: 2686 people (2037 men and 649 women) aged65-85 years living in the general community, recruited from theBritish doctors register and a general practice register inSuffolk.
Main outcome measures: Fracture incidence and total mortality bycause.
Results: After five years 268 men and women had incidentfractures, of whom 147 had fractures in common osteoporotic sites(hip, wrist or forearm, or vertebrae). Relative risks in the vitaminD group compared with the placebo group were 0.78 (95% confidenceinterval 0.61 to 0.99, P=0.04) for any first fracture and 0.67(0.48 to 0.93, P=0.02) for first hip, wrist or forearm, or vertebralfracture. 471 participants died. The relative risk for total mortalityin the vitamin D group compared with the placebo group was 0.88(0.74 to 1.06, P=0.18). Findings were consistent in men and womenand in doctors and the general practicepopulation.
Conclusion: Four monthly supplementation with 100 000IU oral vitamin D may prevent fractures without adverse effectsin men and women living in the generalcommunity.

What is already known in this topic
Vitamin D and calcium supplements are effective in preventing fractures in elderly women

Whether isolated vitamin D supplementation prevents fractures is not clear

What this paper adds
Four monthly oral supplementation with 100 000 IU vitamin D reduces fractures in men and women aged over 65 living in the general community

Total fracture incidence was reduced by 22% and fractures in major osteoporotic sites by 33%


© 2003 BMJ Publishing Group Ltd

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