Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial

Maya Rahme*, Sima Lynn Sharara, Rafic Baddoura, Robert H. Habib, Georges Halaby, Asma Arabi, Ravinder J. Singh, Moustapha Kassem, Ziyad Mahfoud, Maha Hoteit, Rose T. Daher, Darina Bassil, Karim El Ferkh, Ghada El-Hajj Fuleihan

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Resumé

The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects’ mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2, 55% were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C-terminal telopeptide (Cross Laps) levels decreased significantly by 20% to 22% in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high-dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high-dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals.

OriginalsprogEngelsk
TidsskriftJournal of Bone and Mineral Research
Vol/bind32
Udgave nummer7
Sider (fra-til)1486-1495
ISSN0884-0431
DOI
StatusUdgivet - 2017

Fingeraftryk

National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Randomized Controlled Trials
Calcium Citrate
Hip
Body Mass Index
Serum
25-hydroxyvitamin D

Citer dette

Rahme, M., Sharara, S. L., Baddoura, R., Habib, R. H., Halaby, G., Arabi, A., ... El-Hajj Fuleihan, G. (2017). Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial. Journal of Bone and Mineral Research, 32(7), 1486-1495. https://doi.org/10.1002/jbmr.3122
Rahme, Maya ; Sharara, Sima Lynn ; Baddoura, Rafic ; Habib, Robert H. ; Halaby, Georges ; Arabi, Asma ; Singh, Ravinder J. ; Kassem, Moustapha ; Mahfoud, Ziyad ; Hoteit, Maha ; Daher, Rose T. ; Bassil, Darina ; El Ferkh, Karim ; El-Hajj Fuleihan, Ghada. / Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly : A Randomized Controlled Trial. I: Journal of Bone and Mineral Research. 2017 ; Bind 32, Nr. 7. s. 1486-1495.
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title = "Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial",
abstract = "The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects’ mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2, 55{\%} were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C-terminal telopeptide (Cross Laps) levels decreased significantly by 20{\%} to 22{\%} in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high-dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high-dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals.",
keywords = "bone markers, bone mineral density (BMD), Elderly, high-dose vitamin D, IOM",
author = "Maya Rahme and Sharara, {Sima Lynn} and Rafic Baddoura and Habib, {Robert H.} and Georges Halaby and Asma Arabi and Singh, {Ravinder J.} and Moustapha Kassem and Ziyad Mahfoud and Maha Hoteit and Daher, {Rose T.} and Darina Bassil and {El Ferkh}, Karim and {El-Hajj Fuleihan}, Ghada",
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pages = "1486--1495",
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Rahme, M, Sharara, SL, Baddoura, R, Habib, RH, Halaby, G, Arabi, A, Singh, RJ, Kassem, M, Mahfoud, Z, Hoteit, M, Daher, RT, Bassil, D, El Ferkh, K & El-Hajj Fuleihan, G 2017, 'Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial', Journal of Bone and Mineral Research, bind 32, nr. 7, s. 1486-1495. https://doi.org/10.1002/jbmr.3122

Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly : A Randomized Controlled Trial. / Rahme, Maya; Sharara, Sima Lynn; Baddoura, Rafic; Habib, Robert H.; Halaby, Georges; Arabi, Asma; Singh, Ravinder J.; Kassem, Moustapha; Mahfoud, Ziyad; Hoteit, Maha; Daher, Rose T.; Bassil, Darina; El Ferkh, Karim; El-Hajj Fuleihan, Ghada.

I: Journal of Bone and Mineral Research, Bind 32, Nr. 7, 2017, s. 1486-1495.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly

T2 - A Randomized Controlled Trial

AU - Rahme, Maya

AU - Sharara, Sima Lynn

AU - Baddoura, Rafic

AU - Habib, Robert H.

AU - Halaby, Georges

AU - Arabi, Asma

AU - Singh, Ravinder J.

AU - Kassem, Moustapha

AU - Mahfoud, Ziyad

AU - Hoteit, Maha

AU - Daher, Rose T.

AU - Bassil, Darina

AU - El Ferkh, Karim

AU - El-Hajj Fuleihan, Ghada

PY - 2017

Y1 - 2017

N2 - The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects’ mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2, 55% were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C-terminal telopeptide (Cross Laps) levels decreased significantly by 20% to 22% in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high-dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high-dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals.

AB - The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects’ mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2, 55% were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C-terminal telopeptide (Cross Laps) levels decreased significantly by 20% to 22% in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high-dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high-dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals.

KW - bone markers

KW - bone mineral density (BMD)

KW - Elderly

KW - high-dose vitamin D

KW - IOM

U2 - 10.1002/jbmr.3122

DO - 10.1002/jbmr.3122

M3 - Journal article

C2 - 28276596

AN - SCOPUS:85021375372

VL - 32

SP - 1486

EP - 1495

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 7

ER -