Publication: Vitamin D supplement on prevention of fall and fracture: A Meta-analysis of Randomized Controlled Trials
Issued Date
2020-08-21
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ISSN
15365964
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2-s2.0-85089990367
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Mahidol University
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SCOPUS
Bibliographic Citation
Medicine. Vol.99, No.34 (2020), e21506
Suggested Citation
Saran Thanapluetiwong, Api Chewcharat, Kullaya Takkavatakarn, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Paweena Susantitaphong Vitamin D supplement on prevention of fall and fracture: A Meta-analysis of Randomized Controlled Trials. Medicine. Vol.99, No.34 (2020), e21506. doi:10.1097/MD.0000000000021506 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/59192
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Title
Vitamin D supplement on prevention of fall and fracture: A Meta-analysis of Randomized Controlled Trials
Abstract
BACKGROUND: Vitamin D supplement is one of the current possible interventions to reduce fall and fracture. Despite having several studies on vitamin D supplement and fall and fracture reductions, the results are still inconclusive. We conducted a meta-analysis to examine the effect of vitamin D supplement in different forms and patient settings on fall and fracture. METHODS: A systematic literature research was conducted in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) to compare the effects of vitamin D supplements on fall and fracture outcomes. Random-effect models were used to compute the weighted mean difference for continuous variables and the risk ratio for binary variables. RESULTS: Forty-seven RCTs with 58,424 participants were identified reporting on fall outcome. Twenty-four of 47 studies with 40,102 subjects also reported fracture outcome. Major populations were elderly women with age less than 80 years. Overall, vitamin D supplement demonstrated a significant effect on fall reduction, RR = 0.948 (95% CI 0.914-0.984; P = .004, I = 41.52). By subgroup analyses, only vitamin D with calcium supplement significantly reduce fall incidence, RR = 0.881 (95% CI 0.821-0.945; P < .001, I = 49.19). Vitamin D3 supplement decreased incidence of fall but this occurred only when vitamin D3 was supplemented with calcium. Regarding fracture outcome, vitamin D supplement failed to show fracture lowering benefit, RR = 0.949 (95% CI 0.846-1.064; P = .37, I = 37.92). Vitamin D along with calcium supplement could significantly lower fracture rates, RR = 0.859 (95% CI 0.741-0.996; P = .045, I = 25.48). CONCLUSIONS: The use of vitamin D supplement, especially vitamin D3 could reduce incidence of fall. Only vitamin D with calcium supplement showed benefit in fracture reduction.