Endocrinol Metab.  2022 Apr;37(2):344-358. 10.3803/EnM.2021.1374.

Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis

• Kong SH
• Jang HN
• Kim JH
• Kim SW
• Shin CS

• KMID: 2529226
• DOI: http://doi.org/10.3803/EnM.2021.1374

Abstract

Background
Although recent studies comparing various dosages and intervals of vitamin D supplementation have been published, it is yet to be elucidated whether there is an appropriate dose or interval to provide benefit regarding fracture risk. We aimed to assess the published evidence available to date regarding the putative beneficial effects of vitamin D supplements on fractures and falls according to various dosages and intervals.
Methods
We performed a meta-analysis of randomized controlled studies reporting associations between vitamin D supplementation and the risks of fractures and falls in PubMed, EMBASE, and Cochrane library. Studies with supplements of ergocalciferol or calcitriol, those with a number of event ≤10, or those with a follow-up duration of less than 6 months were also excluded.
Results
Thirty-two studies were included in the final analysis. Vitamin D supplementation with daily dose of 800 to 1,000 mg was associated with lower risks of osteoporotic fracture and fall (pooled relative risk [RR], 0.87; 95% confidence interval [CI], 0.78 to 0.97 and RR, 0.91; 95% CI, 0.85 to 0.98), while studies with <800 or >1,000 mg/day did not. Also, among intervals, daily administration of vitamin D was associated with the reduced risk of falls, while intermittent dose was not. Also, patients with vitamin D deficiency showed a significant risk reduction of falls after vitamin D supplementation.
Conclusion
Daily vitamin D dose of 800 to 1,000 IU was the most probable way to reduce the fracture and fall risk. Further studies designed with various regimens and targeted vitamin D levels are required to elucidate the benefits of vitamin D supplements.

Keyword

Fractures, bone; Vitamin D; Dietary supplements; Meta-analysis

Figure

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  Fig. 1. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) diagram of study selection.

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  Fig. 2. Impacts of vitamin D supplements on the risks of (A) any osteoporotic, (B) hip fracture, and (C) fall. CI, confidence interval.

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  Fig. 3. Impacts of vitamin D supplements on the risks of (A) any osteoporotic, (B) hip fracture, and (C) fall according to daily dosages. CI, confidence interval.

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  Fig. 4. Impacts of vitamin D supplements on the risks of (A) any osteoporotic, (B) hip fracture, and (C) fall according to intervals. CI, confidence interval.

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  Fig. 5. Impacts of vitamin D supplements on the risks of any osteoporotic, hip fracture, and fall according to combined calcium supplementation and baseline vitamin D level. CI, confidence interval.

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  Fig. 6. Impacts of 800 to 1,000 IU/day of vitamin D supplements on the risks of (A) osteoporotic fracture and (B) fall according to combined calcium supplementation. CI, confidence interval.

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  Fig. 7. Impacts of vitamin D supplements on the risks of (A) osteoporotic fracture and (B) fall according to institutionalized and communitydwelling populations. CI, confidence interval.

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