A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NoNOF) Study
A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NoNOF) Study
复制标题
DOI：
10.1093/ageing/afh002
复制
发表时间：
2004-01-01
期刊：
影响因子：
6.7
通讯作者：
Hosking, DJ
中科院分区：
文献类型：
--
作者：
Harwood, RH;Sahota, O;Hosking, DJ
背景：髋部骨折的幸存者发生二次髋部骨折的风险是其他患者的5- 10倍。关于二级预防，几乎没有共识。许多人服用钙和维生素D，但支持这一观点的证据是间接的。目的：比较不同的钙和维生素D补充方案对老年妇女髋部骨折后骨生化指标、骨密度和福尔斯率的影响。设计：随机对照试验。地点：老年康复病房。方法：150名先前独立的老年妇女，在髋部骨折手术后招募，被分配接受300，000单位维生素D-2的单次注射，注射维生素D-2加1 g/天口服钙，800单位/天口服维生素D-3加1 g/天钙，或不治疗。随访一年，测量25-羟基维生素D，甲状旁腺激素，骨密度，和福尔斯。结果：平均25-羟基维生素D增加，平均甲状旁腺激素被抑制在所有积极治疗组，更是如此，在组联合口服维生素D和钙。注射维生素D的参与者中有20%在一年后缺乏25-羟基维生素D。骨矿物质密度显示活性治疗组和安慰剂组之间的差异较小，但具有统计学显著性，差异高达4.6%。与controls.Conclusion相比，补充维生素D的组跌倒的相对风险为0.48（95%CI 0.26-0.90）：补充维生素D，无论是口服或注射维生素D，抑制甲状旁腺激素，增加骨密度，减少福尔斯。与钙共同补充的效果可能更显着。注射30万单位的维生素D可能无法持续一整年。
Background: survivors of hip fracture are at 5- to 10-fold risk of a second hip fracture. There is little consensus about secondary prevention. Many are given calcium and vitamin D, but the evidence supporting this is circumstantial.Objective: to compare the effects of different calcium and vitamin D supplementation regimens on bone biochemical markers, bone mineral density and rate of falls in elderly women post-hip fracture.Design: randomised controlled trial.Setting: orthogeriatric rehabilitation ward.Methods: 150 previously independent elderly women, recruited following surgery for hip fracture, were assigned to receive a single injection of 300,000 units of vitamin D-2, injected vitamin D-2 plus 1 g/day oral calcium, 800 units/day oral vitamin D-3 plus 1 g/day calcium, or no treatment. Follow-up was one year, with measurement of 25-hydroxyvitamin D, parathyroid hormone, bone mineral density, and falls.Results: mean 25-hydroxyvitamin D increased and mean parathyroid hormone was suppressed in all the actively treated groups, more so in the group receiving combined oral vitamin D and calcium. Twenty per cent of participants injected with vitamin D were deficient in 25-hydroxyvitamin D a year later. Bone mineral density showed small but statistically significant differences of up to 4.6% between actively treated groups and placebo. Relative risk of falling in the groups supplemented with vitamin D was 0.48 ( 95% CI 0.26-0.90) compared with controls.Conclusion: Vitamin D supplementation, either orally or with injected vitamin D, suppresses parathyroid hormone, increases bone mineral density and reduces falls. Effects may be more marked with calcium co-supplementation. The 300,000 units of injected vitamin D may not last a whole year.