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The effect of cholecalciferol (vitamin D3) on the risk of fall and fracture: a meta-analysis.

QJM : monthly journal of the Association of Physicians (2007-02-20)
C Jackson, S Gaugris, S S Sen, D Hosking
ABSTRACT

We evaluated the effect of supplementation with vitamin D(3) (excluding the potential effect of calcium supplementation) on the risk of fall and fracture, primarily in postmenopausal women, using a systematic literature review of MEDLINE, EMBASE, BIOSIS and the Cochrane Database of Systematic Reviews for the period January 1985 to June 2005. Studies examining the effect of vitamin D versus placebo on the risk of fall or fracture in postmenopausal females were of particular interest. Studies of vitamin D in combination with calcium were also included where the control group was treated with calcium alone. Studies of men and women where results for men and women were not presented separately were included. Nine studies met the inclusion criteria. Our primary meta-analyses examined the effect of vitamin D(3) on the risk of fall or fracture; additional analyses examined baseline and difference between baseline and final levels of several serum and urinary biochemical markers. The pooled relative risk (RR) for vitamin D(3) preventing falls was 0.88 (95%CI 0.78-1.00). For fractures, the pooled RR for vitamin D(3) preventing non-vertebral fractures was 0.96 (95%CI 0.84-1.09) and the pooled RR for vitamin D(3) preventing vertebral fractures was 1.22 (95%CI 0.64-2.31). In a subgroup analysis of post-menopausal women, the pooled RR for vitamin D(3) preventing falls was 0.92 (95%CI 0.75-1.12) and in preventing non-vertebral fractures the pooled RR was 0.81 (95%CI 0.48-1.34). There is a trend towards a reduction in the risk of fall among patients treated with vitamin D(3) alone compared with placebo, suggesting that vitamin D(3) should be an integral part of effective osteoporosis management.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Cholecalciferol, ≥98% (HPLC)
Supelco
Cholecalciferol (Vitamin D3), Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Vitamin D3 solution, 1 mg/mL in ethanol, ampule of 1 mL, certified reference material, Cerilliant®
Supelco
Cholecalciferol (D3), analytical standard
USP
Cholecalciferol, United States Pharmacopeia (USP) Reference Standard
Cholecalciferol, European Pharmacopoeia (EP) Reference Standard
Cholecalciferol for system suitability, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Cholecalciferol, meets USP testing specifications
Sigma-Aldrich
Cholecalciferol, analytical standard