Vuodesta 2007 lähtien on julkaistu yksi systemaattinen katsaus «Cranney A, Horsley T, O'Donnell S ym. Effectivenes...»1.
This SLR included women of reproductive age and postmenopausal women and elderly men. Seventeen RCTs including a total of 58,712 participants were studied in this SLR. Seventeen RCTs evaluated the effect of supplemental vitamin D2 or D3 on BMD, predominantly in populations of late menopausal women. Only one small trial included premenopausal women. Most trials had small sample sizes, were two to three years in duration and used vitamin D doses of ≤ 800 IU daily. Most trials used vitamin D3 and also included calcium > 500 mg as a co-intervention.
Combined results of trials of vitamin D3 plus calcium versus placebo were consistent with a small effect on lumbar spine, femoral neck and total body BMD. The WHI trial found a significant benefit of vitamin D3 400 IU plus 1,000 mg of calcium on total hip BMD. However, in combined trials of vitamin D3 plus calcium versus calcium, a significant increase in BMD was not observed, suggesting vitamin D3 may be of less benefit in calcium replete postmenopausal women. Vitamin D3 alone versus placebo did not show significant increases in BMD, except in one trial that noted an increase in femoral neck BMD. Only a few trials reported the impact of baseline serum 25(OH)D concentrations on BMD and in all of these trials, baseline 25(OH)D was not associated with increased BMD. Overall, there is good evidence that vitamin D3 plus calcium results in small increases in BMD of the spine, total body, femoral neck and total hip. Based on included trials, it was less certain if vitamin D3 alone has a significant effect on BMD.
Vitamin D supplementation together with calcium showed a small effect on lumbar spine, femoral neck and total body BMD. There was no effect of vitamin D alone versus placebo, except for one trial. There was no difference between vitamin D + calcium compared to calcium alone.
The report by Cranney et al «Cranney A, Horsley T, O'Donnell S ym. Effectivenes...»1 concluded that ” there was good evidence for vitamin D + calcium supplementation leading to a small increase in spine, femoral neck, total hip and total body BMD. Based on available studies it was less certain that vitamin D supplementation alone has an effect on BMD.”
The data on the relationship between vitamin D and bone mineral content or bone mineral density is heterogeneous. Based on observational studies, there is fair evidence for a relationship between 25(OH)D and BMD or change in BMD at the femoral neck in the elderly. From intervention studies there is good evidence that supplementation with vitamin D combined with calcium leads to a small increase in spine, femoral neck, total hip and total body BMD. Based on available studies it is less certain that vitamin D supplementation alone has an effect on BMD.