HealthProtocols
← All sources

Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis

JAMA meta-analysis of 33 RCTs (n=51,145) finds no significant association between calcium, vitamin D, or combined supplementation and lower risk of hip, vertebral, or total fractures versus placebo or no treatment in community-dwelling adults older than 50—authors conclude findings do not support routine use for fracture prevention in that broad definition.

Design

  • Included: 33 RCTs, 51,145 community-dwelling adults >50 y
  • Comparisons: calcium, vitamin D, or combined vs placebo or no treatment
  • Outcomes: hip (primary), nonvertebral, vertebral, total fractures

Headline pooled results (abstract)

  • Calcium vs control — hip fracture: RR 1.53 (95% CI 0.97–2.42) — NS
  • Vitamin D vs control — hip fracture: RR 1.21 (0.99–1.47) — NS
  • Ca + vitamin D vs control — hip fracture: RR 1.09 (0.85–1.39) — NS
  • No significant associations for nonvertebral, vertebral, or total fractures across the three supplement strategies

Evidence hygiene

Trials pooled here are predominantly community adults; institutionalised elderly, very high fracture risk, or anti-osteoporosis co-therapy contexts may differ—read subgroup tables before applying to individuals on bisphosphonates etc.

Publication

Zhao JG, Zeng XT, Wang J, Liu L. JAMA. 2017 Dec 26;318(24):2466–2482. PMID 29279934.

Outcomes

  • Fracture Risk
    Events: /
  • Fracture Risk
    Events: /
  • No significant associations for nonvertebral, vertebral, or total fractures across calcium, vitamin D, or combined supplementation versus placebo or no treatment (Zhao et al. 2017 JAMA abstract).
View original paper →