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Effects of intermittent or single high-dose vitamin D supplementation on risk of falls and fractures: a systematic review and meta-analysis

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Abstract

Summary

Previous randomized controlled trials have reported inconsistent findings regarding the effects of high-dose vitamin D supplementation on a risk of falls and fractures. This meta-analysis of 15 trials shows that intermittent or single high-dose vitamin D supplementation had no preventive effect on the risk of falls and fractures and might even increase the risk of falls.

Purpose

Randomized controlled trials (RCTs) have reported controversial findings regarding the associations between intermittent or single high-dose vitamin D supplementation and a risk of falls and fractures in adults. This study aimed to investigate those associations using a systematic review and meta-analysis.

Methods

We searched PubMed, EMBASE, and Cochrane Library from inception to May 25, 2022. Data were extracted for a random-effects meta-analysis to calculate a pooled relative risk (RR) with a 95% confidence interval (CI).

Results

Out of 527 articles, a total of 15 RCTs were included in the final analysis. In a meta-analysis of RCTs, intermittent or single high-dose vitamin D supplementation showed no significant beneficial effect in the prevention of either falls (RR, 1.03 [95% CI, 0.98–1.09]; I2 = 56.6%; n = 11) or fractures (RR, 0.99 [95% CI, 0.87–1.14]; I2 = 48.3%; n = 11). Among the subgroup meta-analyses by various factors, intermittent or single high-dose vitamin D supplementation reduced the risk of fractures in the subgroup meta-analysis of RCTs that included fewer than 1000 participants (RR, 0.74 [95% CI 0.57–0.96]; I2 = 0.0%; n = 5). However, its beneficial effect was not observed in those including 1000 or more participants (RR, 1.06 [95% CI 0.92–1.21]; I2 = 57.5%; n = 6). In contrast, intermittent or single high-dose vitamin D3 supplementation increased the risk of falls on the borderline of statistical significance (RR, 1.06 [95% CI 0.99–1.15]; P = 0.051; I2 = 50.0%; n = 7).

Conclusions

Intermittent or single high-dose vitamin D supplementation had no preventive effect on the risk of falls and fractures and might even increase the risk of falls.

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Data Availability

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Authors and Affiliations

  1. Department of Cancer AI & Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi-Do, 10408, Republic of Korea

    Seung-Kwon Myung

  2. Cancer Epidemiology Branch, Division of Cancer Data Science, Research Institute, National Cancer Center, Goyang, Republic of Korea

    Seung-Kwon Myung

  3. Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Republic of Korea

    Seung-Kwon Myung

  4. Department of Neuroscience, Smith College, Northampton, MA, USA

    Heram Cho

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Seung-Kwon Myung and Heram Cho contributed equally to this work as first author.

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Myung, SK., Cho, H. Effects of intermittent or single high-dose vitamin D supplementation on risk of falls and fractures: a systematic review and meta-analysis. Osteoporos Int 34, 1355–1367 (2023). https://doi.org/10.1007/s00198-023-06761-3

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