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PPT : The Effect of Calcium Plus Vitamin D on the Risk of Fractures

Overview of Calcium and Vitamin D in Fractures (1990-91)
* Little benefit of CaD in preventing early menopausal bone loss.
* Both observational studies and randomized clinical trials support a role for calcium and/or vitamin D in slowing rates of bone loss in older menopausal women.
* Data regarding role of CaD in reducing hip and other fractures not conclusive.

Risk of Hip Fracture between Vitamin D (400 IU/d) & Control Groups
Bischoff-Ferrari, HA., et al. JAMA 2005;293:2257-2264
Achieved 25-Hydroxyvitamin D Level, nmol/L
Hip Fracture Efficacies by Achieved
25-Hydroxyvitamin D Levels in 400 IU/d and 700-800 IU/d Vitamin D-Treated Groups
Bischoff-Ferrari, HA., et al. JAMA 2005;293:2257-2264
* NIH Consensus Development Conference (1994)
- 1,000-1,500 mg /day calcium
* IOM Dietary reference intakes (1997)
- 1,200 mg/day calcium
- 400 IU Vitamin D

What are the Current Calcium and Vitamin D Guidelines?
* To examine the effect of CaD on: – Hip Fractures (Primary) Total Fracture(Secondary)- Colorectal Cancer (secondary)
* Examine the effect of adherence to CaD on the outcomes (sensitivity)
* Determine if there is a threshold effect of CaD on clinical outcomes by stratifying for baseline calcium intake, Vitamin D level, Age and other characteristics.

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