Bone mineral density and bone markers in patients with a recent low-energy fracture: effect of 1 y of treatment with calcium and vitamin D

• Published in: The American journal of clinical nutrition 2007-07, Vol.86 (1), p.251-259
• Main Authors: Hitz, Mette F, Jensen, Jens-Erik B, Eskildsen, Peter C
• Format: Article
• Language: English
• Subjects: 25-hydroxycholecalciferol; Absorptiometry, Photon; adults; age; Aged; Biological and medical sciences; biomarkers; Biomarkers - blood; Bone and Bones - drug effects; Bone and Bones - metabolism; bone density; Bone Density - drug effects; bone fractures; bone metabolism; bone mineralization; Bone Remodeling - drug effects; Bone Remodeling - physiology; bone resorption; calcium; Calcium Carbonate - blood; Calcium Carbonate - pharmacology; Cholecalciferol - blood; Cholecalciferol - pharmacology; collagen; Collagen Type I; dosage; Double-Blind Method; elderly; Feeding. Feeding behavior; Female; Fractures, Bone - pathology; Fractures, Bone - prevention & control; Fundamental and applied biological sciences. Psychology; health status; Humans; Linear Models; low-energy fracture; Male; men; Middle Aged; Osteocalcin - blood; parathyroid hormone; Parathyroid Hormone - blood; patients; Peptide Fragments - blood; Peptides; Procollagen - blood; Prospective Studies; protein subunits; Vertebrates: anatomy and physiology, studies on body, several organs or systems; vitamin D; vitamin-mineral supplements; women
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/86.1.251

BACKGROUND: Low-energy fractures of the hip, forearm, shoulder, and spine are known consequences of osteoporosis. OBJECTIVE: We evaluated the effect of 1 y of treatment with calcium and vitamin D on bone mineral density (BMD) and bone markers in patients with a recent low-energy fracture. DESIGN: In a double-blinded design, patients with fracture of the hip (lower-extremity fracture, or LEF) or upper extremity (UEF) were randomly assigned to receive 3000 mg calcium carbonate + 1400 IU cholecalciferol or placebo (200 IU cholecalciferol). BMD of the hip (HBMD) and lumbar spine (LBMD) were evaluated by dual-energy X-ray absorptiometry, and physical performance was assessed by the timed Up & Go test. Serum concentrations of 25-hydroxycholecalciferol, parathyroid hormone (PTH), telepeptide of type I collagen (ICTP), osteocalcin, and N-terminal propeptide of collagen type I were measured. RESULTS: A total of 122 patients were included (84% women; x ± SD age: 70 ± 11 y); 68% completed the study. In an intention-to-treat analysis, LBMD increased in the intervention group and decreased in the placebo group, and the difference between the groups was significant after 12 mo: 0.931 ± 0.211 compared with 0.848 ± 0.194 (P < 0.05). No significant change was shown for HBMD. The effect of treatment was more pronounced in patients aged