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Bone loss not stopped by monthly 48,000 IU of vitamin D – RCT June 2016

Vitamin D supplementation for 12 months in older people prevents bone loss and suppresses parathyroid hormone levels

Bone Abstracts (2016) 5 P221b | DOI:10.1530/boneabs.5.P221b
43rd Annual European Calcified Tissue Society Congress, Rome, Italy, May 2016
Terry J Aspray1, Roger M Francis1, Elaine McColl2, Thomas Chadwick2, Elaine Stamp2, Ann Prentice3 & Inez Schoenmakers3
1Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK;
2Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK;
3MRC Human Nutrition Research, Cambridge, UK.

Background, subjects and methods: Vitamin D insufficiency in older people in the UK is common and may cause secondary hyperparathyroidism and bone loss. In a randomised, double blind intervention trial to optimise “Vitamin D status in Older People’ (VDOP) three oral dosages of vitamin D3 (12 kIU, 24 kIU or 48 kIU/month) were given for 12 months to 375 participants aged over 70 years (ANOVA) adjustment for covariables with results below presented in ascending dose order.

Results: Baseline characteristics, including BMD, 25OHD and PTH did not differ between the groups (all P>0.05) with a mean (S.D.) 25OHD of 35.5 (20.0) nmol/l, rising by 14.3 (12.6), 25.3 (18.0) and 40.6 (20.2) nmol/l respectively (ANOVA, P<0.001) and resulting in plasma 25OHD levels =25 nmol/l in 99%, 100% and 100% and =50 nmol/l in 63%, 83% and 100% respectively.

BMD at total femur and neck of femur did not change over 12 months (ANOVA for ?BMD and ANCOVA comparisons between doses, all P>0.05). However, PTH decreased for all three doses by -2.9 (18.4), -2.9 (18.1) and -10.6 (15.4) pg/ml respectively (ANOVA P<0.001 and when adjusted for age, sex, weight, height and baseline 25OHD ANCOVA, P<0.001). There were no cases of hypercalcaemia, renal stones or adverse events attributable to the intervention and there were no group difference in the number of falls.

Summary: We conclude that monthly supplementation with 12 kIU, 24 kIU or 48 kIU/month vitamin D is safe and associated with improvements in vitamin D status in this population at risk of vitamin D deficiency. No significant decrease in BMD was seen with any dose, despite an anticipated decrease of ~0.6% in this age/geographical group.