Skip to main content

Advertisement

SpringerLink
Log in

Addressing the Musculoskeletal Components of Fracture Risk with Calcium and Vitamin D: A Review of the Evidence

  • Review
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Abstract

Osteoporotic fractures are an extremely common and serious health problem in the elderly. This article presents the rationale for calcium and vitamin D supplementation in the prevention and treatment of osteoporotic fractures and reviews the literature evidence on the efficacy of this strategy. Two musculoskeletal risk factors are implicated in osteoporotic fractures in the elderly: the loss of bone mass due to secondary hyperparathyroidism and the increased propensity to falls. Calcium and vitamin D reverse secondary hyperparathyroidism with resultant beneficial effects on bone mineral density (BMD). Additionally, calcium and vitamin D supplementation significantly improves body sway and lower extremity strength, reducing the risk of falls. The effects of combined calcium and vitamin D on parathyroid function and BMD provide a strong rationale for the use of this therapy in the prevention and treatment of osteoporosis and osteoporotic fractures. There is general agreement that, in patients with documented osteoporosis, calcium and vitamin D supplementation should be an integral component of the management strategy, along with antiresorptive or anabolic treatment. Frail elderly individuals constitute another major target population for calcium and vitamin D because evidence from randomized studies in institutionalized elderly subjects demonstrates that these supplements reduce osteoporotic fracture risk, particularly in the presence of dietary deficiencies. However, the results of trials in community-dwelling subjects have been equivocal. Within the primary-care setting, further research is required to establish appropriate target subgroups for calcium and vitamin D supplementation; overall, the data are consistent with a benefit individuals with insufficient calcium and/or vitamin D, although patients with documented osteoporosis will derive further benefit in terms of fracture prevention from the addition of an antiresorptive agent.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882

    Article  CAS  PubMed  Google Scholar 

  2. Melton LJ III, Chrischilles EA, Cooper C, Lane AW, Riggs BL (1992) Perspective. How many women have osteoporosis? J Bone Miner Res 7:1005–1010

    PubMed  Google Scholar 

  3. Cummings SR, Black DM, Rubin SM (1989) Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 149:2445–2448

    Article  CAS  PubMed  Google Scholar 

  4. Reginster JY, Gillet P, Gosset C (2001) Secular increase in the incidence of hip fractures in Belgium between 1984 and 1996; need for a concerted public health strategy. Bull World Health Org 79:942–946

    CAS  PubMed  Google Scholar 

  5. Chrischilles EA, Butler CD, Davis CS, Wallace RB (1991) A model of lifetime osteoporosis impact. Arch Intern Med 151:2026–2032

    Article  CAS  PubMed  Google Scholar 

  6. Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    Article  CAS  PubMed  Google Scholar 

  7. Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805

    Article  CAS  PubMed  Google Scholar 

  8. Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674

    Article  CAS  PubMed  Google Scholar 

  9. Lippuner K, von Overbeck J, Perrelet R, Bosshard H, Jaeger P (1997) Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland. Osteoporos Int 7:414–425

    Article  CAS  PubMed  Google Scholar 

  10. Haentjens P, Autier P, Barette M, Boonen S (2001) The economic cost of hip fractures among elderly women. A one-year, prospective, observational cohort study with matched-pair analysis. Belgian Hip Fracture Study Group. J Bone Joint Surg Am 83:493–500

    PubMed  Google Scholar 

  11. Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnee AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int 11:373–380

    Article  CAS  PubMed  Google Scholar 

  12. Boonen S, Autier P, Barette M, Vanderschueren D, Lips P, Haentjens P (2004) Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 15:87–94

    Article  PubMed  CAS  Google Scholar 

  13. Schurch MA, Rizzoli R, Mermillod B, Vasey H, Michel JP, Bonjour JP (1996) A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 11:1935–1942

    CAS  PubMed  Google Scholar 

  14. Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, Gosset C (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15:507–514

    Article  CAS  PubMed  Google Scholar 

  15. Cree M, Soskolne CL, Belseck E, Hornig J, McElhaney JE, Brant R, Suarez-Almazor M (2000) Mortality and institutionalization following hip fracture. J Am Geriatr Soc 48:283–288

    CAS  PubMed  Google Scholar 

  16. Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42

    Article  CAS  PubMed  Google Scholar 

  17. Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561

    Article  CAS  PubMed  Google Scholar 

  18. Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112

    Article  PubMed  Google Scholar 

  19. Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S

    Article  CAS  PubMed  Google Scholar 

  20. Chapurlat RD, Bauer DC, Nevitt M, Stone K, Cummings SR (2003) Incidence and risk factors for a second hip fracture in elderly women. The study of osteoporotic fractures. Osteoporos Int 14:130–136

    CAS  PubMed  Google Scholar 

  21. Colon-Emeric C, Kuchibhatla M, Pieper C, Hawkes W, Fredman L, Magaziner J, Zimmerman S, Lyles KW (2003) The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int 14:879–883

    Article  PubMed  Google Scholar 

  22. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323

    Article  CAS  PubMed  Google Scholar 

  23. Gold DT (1996) The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 18:185S–189S

    Article  CAS  PubMed  Google Scholar 

  24. Hall SE, Criddle RA, Comito TL, Prince RL (1999) A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture. Osteoporos Int 9:508–515

    Article  CAS  PubMed  Google Scholar 

  25. Adachi JD, Ioannidis G, Olszynski WP, Brown JP, Hanley DA, Sebaldt RJ, Petrie A, Tenenhouse A, Stephenson GF, Papaioannou A, Guyatt GH, Goldsmith CH (2002) The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women. BMC Musculoskelet Disord 3:11

    Article  PubMed  Google Scholar 

  26. Leidig-Bruckner G, Minne HW, Schlaich C, Wagner G, Scheidt-Nave C, Bruckner T, Gebest HJ, Ziegler R (1997) Clinical grading of spinal osteoporosis: quality of life components and spinal deformity in women with chronic low back pain and women with vertebral osteoporosis. J Bone Miner Res 12:663–675

    Article  CAS  PubMed  Google Scholar 

  27. Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800

    CAS  PubMed  Google Scholar 

  28. Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G (1998) Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8:261–267

    Article  CAS  PubMed  Google Scholar 

  29. Melton LJ III, Atkinson EJ, Cooper C, O’Fallon WM, Riggs BL (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10:214–221

    Article  PubMed  Google Scholar 

  30. Ismail AA, Cockerill W, Cooper C, Finn JD, Abendroth K, Parisi G, Banzer D, Benevolenskaya LI, Bhalla AK, Armas JB, Cannata JB, Delmas PD, Dequeker J, Dilsen G, Eastell R, Ershova O, Falch JA, Felsch B, Havelka S, Hoszowski K, Jajic I, Kragl U, Johnell O, Lopez VA, Lorenc R, Lyritis G, Marchand F, Masaryk P, Matthis C, Miazgowski T, Pols HA, Poor G, Rapado A, Raspe HH, Reid DM, Reisinger W, Janott J, Scheidt-Nave C, Stepan J, Todd C, Weber K, Woolf AD, Ambrecht G, Gowin W, Felsenberg D, Lunt M, Kanis JA, Reeve J, Silman AJ, O’Neill TW (2001) Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int 12:85–90

    Article  CAS  PubMed  Google Scholar 

  31. Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148

    CAS  PubMed  Google Scholar 

  32. Colditz GA, Manson JE, Hankinson SE (1997) The Nurses’ Health Study: 20-year contribution to the understanding of health among women. J Womens Health 6:49–62

    Article  CAS  PubMed  Google Scholar 

  33. Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162:2217–2222

    Article  PubMed  Google Scholar 

  34. Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am 82:1063–1070

    PubMed  Google Scholar 

  35. Port L, Center J, Briffa NK, Nguyen T, Cumming R, Eisman J (2003) Osteoporotic fracture: missed opportunity for intervention. Osteoporos Int 14:780–784

    Article  PubMed  Google Scholar 

  36. Gehlbach SH, Bigelow C, Heimisdottir M, May S, Walker M, Kirkwood JR (2000) Recognition of vertebral fracture in a clinical setting. Osteoporos Int 11:577–582

    Article  CAS  PubMed  Google Scholar 

  37. Gehlbach SH, Fournier M, Bigelow C (2002) Recognition of osteoporosis by primary care physicians. Am J Public Health 92:271–273

    PubMed  Google Scholar 

  38. Bahl S, Coates PS, Greenspan SL (2003) The management of osteoporosis following hip fracture: have we improved our care? Osteoporos Int 14:884–888

    Article  PubMed  Google Scholar 

  39. Nguyen TV, Center JR, Eisman JA (2004) Osteoporosis: underrated, underdiagnosed and undertreated. Med J Aust 180:S18–S22

    PubMed  Google Scholar 

  40. Panneman MJ, Lips P, Sen SS, Herings RM (2004) Undertreatment with anti-osteoporotic drugs after hospitalization for fracture. Osteoporos Int 15:120–124

    Article  PubMed  Google Scholar 

  41. Hauselmann HJ, Rizzoli R (2003) A comprehensive review of treatments for postmenopausal osteoporosis. Osteoporos Int 14:2–12

    Article  CAS  PubMed  Google Scholar 

  42. Boonen S, Haentjens P, Vandenput L, Vanderschueren D (2004) Preventing osteoporotic fractures with antiresorptive therapy: implications of microarchitectural changes. J Intern Med 255:1–12

    Article  CAS  PubMed  Google Scholar 

  43. Boonen S, Rizzoli R, Meunier PJ, Stone M, Nuki G, Syversen U, Lehtonen-Veromaa M, Lips P, Johnell O, Reginster JY (2004) The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. Osteoporos Int 15:511–519

    Article  CAS  PubMed  Google Scholar 

  44. Kamel HK (2004) Underutilization of calcium and vitamin D supplements in an academic long-term care facility. J Am Med Dir Assoc 5:98–100

    Article  PubMed  Google Scholar 

  45. Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, Nevitt MC, Cummings SR (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18:1947–1954

    Article  PubMed  Google Scholar 

  46. Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, LaCroix AZ, Black DM (2002) Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs. Am J Med 112:281–289

    Article  CAS  PubMed  Google Scholar 

  47. Heaney RP (2003) Is the paradigm shifting? Bone 33:457–465

    Article  PubMed  Google Scholar 

  48. Bono CM, Einhorn TA (2003) Overview of osteoporosis: pathophysiology and determinants of bone strength. Eur Spine J 12(suppl 2):S90–S96

    Article  PubMed  Google Scholar 

  49. Boonen S, Vanderschueren D, Cheng XG, Verbeke G, Dequeker J, Geusens P, Broos P, Bouillon R (1997) Age-related (type II) femoral neck osteoporosis in men: biochemical evidence for both hypovitaminosis D- and androgen deficiency-induced bone resorption. J Bone Miner Res 12:2119–2126

    Article  CAS  PubMed  Google Scholar 

  50. Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ (1996) Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. EPIDOS Study Group. J Clin Endocrinol Metab 81:1129–1133

    Article  CAS  PubMed  Google Scholar 

  51. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    Article  CAS  PubMed  Google Scholar 

  52. Lips P, Netelenbos JC, Jongen MJ, van Ginkel FC, Althuis AL, van Schaik CL, van der Vijgh WJ, Vermeiden JP, van der MC (1982) Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Relat Res 4:85–93

    Article  CAS  PubMed  Google Scholar 

  53. Bouillon RA, Auwerx JH, Lissens WD, Pelemans WK (1987) Vitamin D status in the elderly: seasonal substrate deficiency causes 1,25-dihydroxycholecalciferol deficiency. Am J Clin Nutr 45:755–763

    CAS  PubMed  Google Scholar 

  54. Lips P, Wiersinga A, van Ginkel FC, Jongen MJ, Netelenbos JC, Hackeng WH, Delmas PD, van der Vijgh WJ (1988) The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 67:644–650

    CAS  PubMed  Google Scholar 

  55. Pattanaungkul S, Riggs BL, Yergey AL, Vieira NE, O’Fallon WM, Khosla S (2000) Relationship of intestinal calcium absorption to 1,25-dihydroxyvitamin D [1,25(OH)2D] levels in young versus elderly women: evidence for age-related intestinal resistance to 1,25(OH)2D action. J Clin Endocrinol Metab 85:4023–4027

    Article  CAS  PubMed  Google Scholar 

  56. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, Nickelsen T (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86:1212–1221

    Article  CAS  PubMed  Google Scholar 

  57. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443

    Article  CAS  PubMed  Google Scholar 

  58. Lips P, Hackeng WH, Jongen MJ, van Ginkel FC, Netelenbos JC (1983) Seasonal variation in serum concentrations of parathyroid hormone in elderly people. J Clin Endocrinol Metab 57:204–206

    Article  CAS  PubMed  Google Scholar 

  59. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  CAS  PubMed  Google Scholar 

  60. Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  CAS  PubMed  Google Scholar 

  61. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporosis Int 16:713–716

    Article  CAS  Google Scholar 

  62. Heaney RP, Dowell MS, Hale CA, Bendich A (2003) Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22:142–146

    CAS  PubMed  Google Scholar 

  63. Melton LJI, Chao EYS, Lane J (1998) Biomechanical aspects of fractures. In: Riggs BL, Melton LJ (eds), Osteoporosis: Etiology, Diagnosis, and Management. Raven Press, New York, pp 111–131

    Google Scholar 

  64. Campbell AJ, Reinken J, Allan BC, Martinez GS (1981) Falls in old age: a study of frequency and related clinical factors. Age Ageing 10:264–270

    CAS  PubMed  Google Scholar 

  65. Tinetti ME, Williams CS (1998) The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci 53:M112–M119

    CAS  PubMed  Google Scholar 

  66. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707

    Article  CAS  PubMed  Google Scholar 

  67. Tinetti ME, Williams CS (1997) Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 337:1279–1284

    Article  CAS  PubMed  Google Scholar 

  68. Geusens P, Milisen K, Dejaeger E, Boonen S (2003) Falls and fractures in postmenopausal women: a review. J Br Menopause Soc 9:101–106

    Article  PubMed  Google Scholar 

  69. Englander F, Hodson TJ, Terregrossa RA (1996) Economic dimensions of slip and fall injuries. J Forensic Sci 41:733–746

    CAS  PubMed  Google Scholar 

  70. Tinetti ME (1987) Factors associated with serious injury during falls by ambulatory nursing home residents. J Am Geriatr Soc 35:644–648

    CAS  PubMed  Google Scholar 

  71. Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 261:2663–2668

    Article  CAS  PubMed  Google Scholar 

  72. McKane WR, Khosla S, Egan KS, Robins SP, Burritt MF, Riggs BL (1996) Role of calcium intake in modulating age-related increases in parathyroid function and bone resorption. J Clin Endocrinol Metab 81:1699–1703

    Article  CAS  PubMed  Google Scholar 

  73. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE, Falconer G, Green CL (1995) Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr 61:1140–1145

    CAS  PubMed  Google Scholar 

  74. Lips P, Wiersinga A, van Ginkel FC, Jongen MJ, Netelenbos JC, Hackeng WH, Delmas PD, van der Vijgh WJ (1988) The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 67:644–650

    CAS  PubMed  Google Scholar 

  75. Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058

    Article  CAS  PubMed  Google Scholar 

  76. Chel VG, Ooms ME, Popp-Snijders C, Pavel S, Schothorst AA, Meulemans CC, Lips P (1998) Ultraviolet irradiation corrects vitamin D deficiency and suppresses secondary hyperparathyroidism in the elderly. J Bone Miner Res 13:1238–1242

    Article  CAS  PubMed  Google Scholar 

  77. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642

    Article  CAS  PubMed  Google Scholar 

  78. Brazier M, Kamel S, Maamer M, Agbomson F, Elesper I, Garabedian M, Desmet G, Sebert JL (1995) Markers of bone remodeling in the elderly subject: effects of vitamin D insufficiency and its correction. J Bone Miner Res 10:1753–1761

    Article  CAS  PubMed  Google Scholar 

  79. Himmelstein S, Clemens TL, Rubin A, Lindsay R (1990) Vitamin D supplementation in elderly nursing home residents increases 25(OH)D but not 1,25(OH)2D. Am J Clin Nutr 52:701–706

    CAS  PubMed  Google Scholar 

  80. Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058

    Article  CAS  PubMed  Google Scholar 

  81. Adams JS, Kantorovich V, Wu C, Javanbakht M, Hollis BW (1999) Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 84:2729–2730

    Article  CAS  PubMed  Google Scholar 

  82. Prestwood KM, Pannullo AM, Kenny AM, Pilbeam CC, Raisz LG (1996) The effect of a short course of calcium and vitamin D on bone turnover in older women. Osteoporos Int 6:314–319

    Article  CAS  PubMed  Google Scholar 

  83. Simpson RU, Thomas GA, Arnold AJ (1985) Identification of 1,25-dihydroxyvitamin D3 receptors and activities in muscle. J Biol Chem 260:8882–8891

    CAS  PubMed  Google Scholar 

  84. Bischoff HA, Borchers M, Gudat F, Duermueller U, Theiler R, Stahelin HB, Dick W (2001) In situ detection of 1,25-dihydroxyvitamin D3 receptor in human skeletal muscle tissue. Histochem J 33:19–24

    Article  CAS  PubMed  Google Scholar 

  85. Sorensen OH, Lund B, Saltin B, Lund B, Andersen RB, Hjorth L, Melsen F, Mosekilde L (1979) Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (Colch) 56:157–161

    CAS  Google Scholar 

  86. Bischoff-Ferrari HA, Borchers M, Gudat F, Durmuller U, Stahelin HB, Dick W (2004) Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res 19:265–269

    Article  CAS  PubMed  Google Scholar 

  87. Boland R (1986) Role of vitamin D in skeletal muscle function. Endocr Rev 7:434–448

    Article  CAS  PubMed  Google Scholar 

  88. Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Andersen H, Charles P, Eriksen EF (2000) Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int 66:419–424

    Article  CAS  PubMed  Google Scholar 

  89. Bischoff HA, Stahelin HB, Urscheler N, Ehrsam R, Vonthein R, Perrig-Chiello P, Tyndall A, Theiler R (1999) Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehabil 80:54–58

    Article  CAS  PubMed  Google Scholar 

  90. Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351

    Article  CAS  PubMed  Google Scholar 

  91. Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 15:1113–1118

    Article  CAS  PubMed  Google Scholar 

  92. Latham NK, Anderson CS, Lee A, Bennett DA, Moseley A, Cameron ID (2003) A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 51:291–299

    Article  PubMed  Google Scholar 

  93. Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged ≥ 60 y. Am J Clin Nutr 80:752–758

    CAS  PubMed  Google Scholar 

  94. Dukas L, Bischoff HA, Lindpaintner LS, Schacht E, Birkner-Binder D, Damm TN, Thalmann B, Stahelin HB (2004) Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily. J Am Geriatr Soc 52:230–236

    Article  PubMed  Google Scholar 

  95. Graafmans WC, Ooms ME, Hofstee HM, Bezemer PD, Bouter LM, Lips P (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 143:1129–1136

    CAS  PubMed  Google Scholar 

  96. Porthouse J, Cockayne S, King C, Saxon L, Steele E, Aspray T, Baverstock M, Birks Y, Dumville J, Francis R, Iglesias C, Puffer S, Sutcliffe A, Watt I, Torgerson DJ (2005) Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 330:1003

    Article  CAS  PubMed  Google Scholar 

  97. RECORD Trial Group (2005) Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium or Vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 365:1621–1628

    Article  CAS  Google Scholar 

  98. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291:1999–2006

    Article  CAS  PubMed  Google Scholar 

  99. Chapuy MC, Arlot ME, Delmas PD, Meunier PJ (1994) Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 308:1081–1082

    CAS  PubMed  Google Scholar 

  100. Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13:257–264

    Article  CAS  PubMed  Google Scholar 

  101. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670–676

    Article  CAS  PubMed  Google Scholar 

  102. Larsen ER, Mosekilde L, Foldspang A (2004) Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population-based 3-year intervention study. J Bone Miner Res 19:370–378

    Article  CAS  PubMed  Google Scholar 

  103. Eastell R, Barton I, Hannon RA, Chines A, Garnero P, Delmas PD (2003) Relationship of early changes in bone resorption to the reduction in fracture risk with risedronate. J Bone Miner Res 18:1051–1056

    Article  CAS  PubMed  Google Scholar 

  104. Bauer DC, Black DM, Garnero P, Hochberg M, Ott S, Orloff J, Thompson DE, Ewing SK, Delmas PD (2004) Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial. J Bone Miner Res 19:1250–1258

    Article  PubMed  Google Scholar 

  105. Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM (1996) Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med 124:400–406

    CAS  PubMed  Google Scholar 

  106. Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI (2002) Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17:709–715

    Article  CAS  PubMed  Google Scholar 

  107. Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326:469

    Article  CAS  PubMed  Google Scholar 

  108. Heikinheimo RJ, Inkovaara JA, Harju EJ, Haavisto MV, Kaarela RH, Kataja JM, Kokko AM, Kolho LA, Rajala SA (1992) Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 51:105–110

    Article  CAS  PubMed  Google Scholar 

  109. Smith H, Anderson F, Raphael H, Crozier S, Cooper C (2004) Annual intramuscular vitamin D and fractures in the elderly. J Bone Miner Res 19:A1032

    Article  CAS  Google Scholar 

  110. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293:2257–2264

    Article  CAS  PubMed  Google Scholar 

  111. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (2000) Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr 72:745–750

    CAS  PubMed  Google Scholar 

  112. Steel SA, Albertazzi P, Howarth EM, Purdie DW (2003) Factors affecting long-term adherence to hormone replacement therapy after screening for osteoporosis. Climacteric 6:96–103

    CAS  PubMed  Google Scholar 

  113. Patel S, Ogunremi L, Chinappen U (2003) Acceptability and compliance with hip protectors in community-dwelling women at high risk of hip fracture. Rheumatology (Oxford) 42:769–772

    Article  CAS  Google Scholar 

  114. Rees TP, Howe I (2001) A randomised, single-blind, crossover comparison of the acceptability of the calcium and vitamin D3 supplements Calcichew D3 Forte and Ad Cal D3 in elderly patients. Curr Med Res Opin 16:245–251

    Article  CAS  PubMed  Google Scholar 

  115. Simon JA, Lewiecki EM, Smith ME, Petruschke RA, Wang L, Palmisano JJ (2002) Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: a multicenter, randomized, open-label, crossover study. Clin Ther 24:1871–1886

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

S. B. is a senior clinical investigator of the Fund for Scientific Research–Flanders, Belgium (F.W.O.– Vlaanderen) and holder of the Leuven University Chair in Metabolic Bone Diseases. This work was supported by grant G.0171.03 from the Fund for Scientific Research–Flanders, to S. B.

Author information

Authors and Affiliations

  1. Leuven University Center for Metabolic Bone Diseases and Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium

    S. Boonen

  2. Division of Aging and Division of Rheumatology, Immunology and Allergy, The Robert B. Brigham Arthritis and Musculoskeletal Diseases Clinical Research Center, Brigham and Women’s Hospital, Boston, MA, USA

    H. A. Bischoff-Ferrari

  3. MRC Environmental Epidemiology Unit and University of Southampton School of Medicine, Southampton General Hospital, Southampton, UK

    C. Cooper

  4. Department of Endocrinology, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands

    P. Lips

  5. Institution for Medical Sciences and Surgical Sciences, University Hospital, Uppsala, Sweden

    O. Ljunggren

  6. Université Paris-Descartes, Faculty de Medecine R. Llaennec, Lyon, France

    P. J. Meunier

  7. Unité d’Exploration de l’Os et du Cartilage, Liège, Belgium

    J.-Y. Reginster

Authors
  1. S. Boonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. A. Bischoff-Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Lips
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Ljunggren
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. J. Meunier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J.-Y. Reginster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Boonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boonen, S., Bischoff-Ferrari, H.A., Cooper, C. et al. Addressing the Musculoskeletal Components of Fracture Risk with Calcium and Vitamin D: A Review of the Evidence. Calcif Tissue Int 78, 257–270 (2006). https://doi.org/10.1007/s00223-005-0009-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00223-005-0009-8

Keywords

Search

Navigation