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Calcium Plus Vitamin D Supplementation Has Limited Effects On Femoral Geometric Strength In Older Postmenopausal Women: The Women’s Health Initiative

Rebecca D. Jackson, Nicole C. Wright, T. Beck, D. Sherrill, J. Cauley, Cora E. Lewis, A. LaCroix, Meryl S. Leboff, S. Going, T. Bassford, Zhao Chen
Published 2010 · Medicine

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Calcium plus vitamin D (CaD) supplementation has a modest but significant effect on slowing loss of femoral bone mass and reducing risk of hip fractures in adherent postmenopausal women. The goal of this study was to determine if CaD supplementation influences hip structural parameters that are associated with fracture risk. We studied 1,970 postmenopausal women enrolled in the Women’s Health Initiative randomized controlled trial of CaD at one of three bone mineral density (BMD) clinical centers. Hip structural analysis software measured BMD and strength parameters on DXA scans at three regions: femoral narrow neck, intertrochanter, and shaft. Random effects models were used to test the average differences in hip BMD and geometry between intervention and placebo. There was greater preservation of hip BMD at the narrow neck with CaD relative to placebo across 6 years of intervention. CaD also altered the underlying cross-sectional geometry at the narrow neck in the direction of greater strength, with small increases in cross-sectional area and section modulus and a decrease in buckling ratio with CaD relative to placebo. While trends at both the intertrochanter and shaft regions were similar to those noted at the narrow neck, no significant intervention effects were evident. There was no significant interaction of CaD and age or baseline calcium levels for hip structural properties. CaD supplementation is associated with modest beneficial effects on hip structural features at the narrow neck, which may explain some of the benefit of CaD in reducing hip fracture risk.
This paper references
Vitamin D and calcium: a systemic review of health outcomes. Evidence reports/technology assessments 183
MBE Chung (2009)
10.1007/s00198-005-0028-3
Structural effects of raloxifene on the proximal femur: results from the multiple outcomes of raloxifene evaluation trial
K. Uusi-Rasi (2005)
10.1016/S1360-8592(98)80042-9
A structural approach
T. W. Myers (1998)
10.1359/jbmr.080802
Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures
S. Kaptoge (2008)
10.1002/JBMR.5650040112
Histomorphometric effects of calcium or calcium plus 25‐hydroxyvitamin D3 therapy in senile osteoporosis
E. Orwoll (1989)
10.1097/00004424-199001000-00004
Predicting femoral neck strength from bone mineral data. A structural approach.
T. J. Beck (1990)
10.1210/JC.2006-1525
Vitamin D status predicts physical performance and its decline in older persons.
I. Wicherts (2007)
10.1359/jbmr.080707
Hormone Therapy Improves Femur Geometry Among Ethnically Diverse Postmenopausal Participants in the Women's Health Initiative Hormone Intervention Trials
Z. Chen (2008)
10.1111/j.1532-5415.2007.01048.x
A Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing Home Residents: A Randomized, Multiple‐Dose Study
K. Broe (2007)
10.1016/J.BONE.2005.03.003
Effects of teriparatide [rhPTH (1-34)] treatment on structural geometry of the proximal femur in elderly osteoporotic women.
K. Uusi-Rasi (2005)
10.1007/s00198-002-1345-4
Bone strength and its determinants
P. Ammann (2003)
10.1016/0021-9290(84)90010-1
Non-invasive measurement of long bone cross-sectional moment of inertia by photon absorptiometry.
R. B. Martin (1984)
10.1016/S0140-6736(96)07088-2
Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures
D. Black (1996)
10.1359/jbmr.2003.18.10.1766
Structural and Biomechanical Basis of Sexual Dimorphism in Femoral Neck Fragility Has Its Origins in Growth and Aging
Y. Duan (2003)
10.1016/S1047-2797(03)00046-2
The Women's Health Initiative calcium-vitamin D trial: overview and baseline characteristics of participants.
R. Jackson (2003)
10.1210/edrv.23.4.0486
Meta-Analyses of Therapies for Postmenopausal Osteoporosis
A. Cranney (2002)
10.1001/JAMA.293.18.2257
Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials.
H. Bischoff-Ferrari (2005)
Ran - domised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures . Fracture Intervention Trial Research Group
A Cranney (1996)
Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake.
L. Dukas (2005)
10.1359/jbmr.2000.15.6.1113
Effects of a Short‐Term Vitamin D and Calcium Supplementation on Body Sway and Secondary Hyperparathyroidism in Elderly Women
M. Pfeifer (2000)
10.1007/s001980200023
Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study
M. C. Chapuy (2002)
10.1016/S0197-2456(97)00078-0
Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group.
G. Anderson (1998)
10.1016/J.BONE.2005.03.007
In vivo short-term precision of hip structure analysis variables in comparison with bone mineral density using paired dual-energy X-ray absorptiometry scans from multi-center clinical trials.
B. C. C. Khoo (2005)
10.1093/AJCN/80.3.752
Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y.
H. Bischoff-Ferrari (2004)
Mortality and osteoporotic fractures: is the link causal, and is it modifiable?
G. Teng (2008)
10.1001/JAMA.291.16.1999
Effect of Vitamin D on falls: a meta-analysis.
H. Bischoff-Ferrari (2004)
10.1001/JAMA.291.14.1701
Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial.
G. Anderson (2004)
10.1001/JAMA.288.3.321
Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial
J. Rossouw (2002)
10.1210/ER.2001-2002
Meta-analyses of therapies for postmenopausal osteoporosis. II. Meta-analysis of alendronate for the treatment of postmenopausal women.
A. Cranney (2002)
Vitamin D and calcium: a systematic review of health outcomes.
M. Chung (2009)
10.1359/JBMR.050508
Effect of Hormone Replacement, Alendronate, or Combination Therapy on Hip Structural Geometry: A 3‐Year, Double‐Blind, Placebo‐Controlled Clinical Trial
S. Greenspan (2005)
10.1210/jc.2008-1807
Once-monthly oral ibandronate improves biomechanical determinants of bone strength in women with postmenopausal osteoporosis.
E. Lewiecki (2009)
10.1007/s00198-006-0071-8
Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women
K. Faulkner (2006)
Higher 25hydroxyvitamin D concentrations are associated with better lowerextremity function in both active and inactive persons aged C 60 y
HA Bischoff-Ferrari (2004)
10.1016/S1047-2797(98)00055-6
Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
R. Patterson (1999)
10.1359/jbmr.2000.15.12.2297
Structural Trends in the Aging Femoral Neck and Proximal Shaft: Analysis of the Third National Health and Nutrition Examination Survey Dual‐Energy X‐Ray Absorptiometry Data
T. J. Beck (2000)
10.1093/GERONA/55.9.M498
Recovery from hip fracture in eight areas of function.
J. Magaziner (2000)
10.1016/S0140-6736(02)08657-9
Epidemiology and outcomes of osteoporotic fractures
S. Cummings (2002)
10.1359/jbmr.061115
Geometric Indices of Bone Strength Are Associated With Physical Activity and Dietary Calcium Intake in Healthy Older Women
M. K. Nurzenski (2007)
10.1016/S0140-6736(07)61342-7
Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis
B. Tang (2007)
10.1056/NEJMOA055218
Calcium plus vitamin D supplementation and the risk of fractures.
R. Jackson (2006)
10.1359/jbmr.070712
Femoral Neck BMD Is a Strong Predictor of Hip Fracture Susceptibility in Elderly Men and Women Because It Detects Cortical Bone Instability: The Rotterdam Study
F. Rivadeneira (2007)
10.1359/jbmr.061113
Incidence and Economic Burden of Osteoporosis‐Related Fractures in the United States, 2005–2025
R. Burge (2007)
10.1016/J.BONE.2004.12.009
Influence of estrogen therapy at conventional and high doses on the degree of mineralization of iliac bone tissue: a quantitative microradiographic analysis in postmenopausal women.
G. Boivin (2005)
10.1007/s00198-009-1056-1
Hip structural geometry and incidence of hip fracture in postmenopausal women: what does it add to conventional bone mineral density?
A. LaCroix (2009)
Effectiveness and safety of vitamin D in relation to bone health.
A. Cranney (2007)



This paper is referenced by
10.3386/W19054
Unobservable Selection and Coefficient Stability: Theory and Validation
E. Oster (2013)
Forsteo Observational Study ( EFOS ) 18-month follow-up of Greek women completing teriparatide treatment for osteoporosis
K. Aloumanis (2012)
10.1201/B18490-7
Calcium and Vitamin D: Nutritional Role and the Benefits and Risks of Dietary Supplements in Health Promotion
A. Phillips (2015)
10.1002/14651858.CD000227.pub4
Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men.
A. Avenell (2014)
Effect of Early Life Vitamin D Supplementation on Bone Development
Kristina A. Fielding (2013)
10.1007/s00198-019-04843-9
Dairy- and supplement-based calcium intake in adulthood and vertebral dimensions in midlife—the Northern Finland Birth Cohort 1966 Study
P. Oura (2019)
10.1016/j.jocd.2011.06.003
Rheumatoid arthritis is associated with less optimal hip structural geometry.
N. Wright (2012)
10.1007/s00198-019-05275-1
Effect of vitamin D on bone strength in older African Americans: a randomized controlled trial
R. Dhaliwal (2020)
10.1002/14651858.CD007470.pub3
Vitamin D supplementation for prevention of mortality in adults.
G. Bjelakovic (2014)
10.1039/d0fo00787k
Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.
C. Liu (2020)
10.4081/reumatismo.2014.788
Vitamin D and rheumatic diseases.
M. Rossini (2014)
10.1002/9781118823408.CH7
Bone and muscle ageing
Joana Carvalho (2015)
10.1016/j.maturitas.2020.05.020
Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health.
A. Capozzi (2020)
Influence of Maternal Dietary Diversity on the Risk of Low Birth Weight of Neonates in the Cape Coast Metropolis of Ghana
Dan Yedu Quansah (2015)
10.1002/jbmr.3879
Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative
H. Ochs-Balcom (2019)
Unobservable Selection and Coecient Stability: Theory and Validation in Public Health
E. Oster (2013)
10.1017/S0007114513001219
A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women.
Sangah Shin (2013)
10.1016/j.jocd.2011.04.007
Lean mass predicts hip geometry in men and women with non-insulin-requiring type 2 diabetes mellitus.
K. F. Moseley (2011)
10.24985/KJSS.2013.24.3.415
Influence of Resistance Exercise and Calcium Supplement on Body Composition, Physical Fitness, Glucose Metabolism, andBlood Lipids in Obese Elementary School Students
K. T. Kim (2013)
10.1210/jc.2014-4320
The Association of Vitamin D With Femoral Neck Strength: An Additional Evidence of Vitamin D on Bone Health.
H. Kim (2015)
10.1002/14651858.CD007469.pub2
Vitamin D supplementation for prevention of cancer in adults.
G. Bjelakovic (2014)
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