Abstract
In consideration and critical review of four recent meta-analyses on vitamin D and fracture prevention, vitamin D supplementation with or without calcium is supported among older adults age 65 years and older at risk of vitamin D deficiency and fractures if given in daily or equivalent weekly or monthly doses of 800 to 1000 IU and with good adherence. Vitamin D supplementation might not be effective in primary prevention among adults age 50 years and older without vitamin D deficiency and osteoporosis; however, clinical trials on primary prevention are limited. Notably, large annual bolus administration of vitamin D is detrimental with regard to falls and fractures among older adults at risk of fractures and should not be continued in clinical care. Larger monthly doses of 100,000 IU need further evaluation with respect to efficacy and safety.
Zusammenfassung
Nach kritischer Überprüfung von vier aktuellen Metaanalysen zu Vitamin D und Frakturprävention ist die Vitamin-D-Supplementierung mit oder ohne Kalzium bei ≥65-jährigen Erwachsenen mit Risiko eines Vitamin-D-Mangels und von Frakturen zu befürworten, wenn bei guter Adhärenz täglich oder äquivalent wöchentlich bis monatlich Dosen von 800 bis 1000 IU pro Tag gegeben werden. Eine Vitamin-D-Supplementierung ist in der Primärprävention bei ≥50-jährigen Erwachsenen ohne Vitamin-D-Mangel und Osteoporose möglicherweise nicht wirksam; allerdings ist die klinische Studienlage zur Primärprävention beschränkt. Anzumerken ist, dass die Applikation hoher jährlicher Vitamin-D-Boli bei älteren Patienten mit Frakturrisiko negative Effekte auf das Sturz- und Frakturrisiko hat und in der Klinik keine Anwendung mehr finden sollte. Höhere monatliche Dosen von 100.000 IU müssen bezüglich ihrer Wirksamkeit und Sicherheit weiter untersucht werden.
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H.A. Bischoff-Ferrari has received speaker fees from Nestlé, Roche, Pfizer, WILD, Sandoz, and Vifor, and received investigator initiated and independent research funding from DSM Nutritional Products, WILD, Pfizer, and Besins.
For this article no studies with human participants or animals were performed by the author. All studies performed were in accordance with the ethical standards indicated in each case.
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Bischoff-Ferrari, H.A. Should vitamin D administration for fracture prevention be continued?. Z Gerontol Geriat 52, 428–432 (2019). https://doi.org/10.1007/s00391-019-01573-9
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DOI: https://doi.org/10.1007/s00391-019-01573-9