Effects of three-monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: A randomized controlled trial

被引:104
作者
Glendenning, Paul [2 ,3 ,4 ]
Zhu, Kun [1 ,2 ]
Inderjeeth, Charles [2 ,5 ]
Howat, Peter [6 ]
Lewis, Joshua R. [1 ,2 ]
Prince, Richard L. [1 ,2 ]
机构
[1] Sir Charles Gairdner Hosp, Dept Endocrinol & Diabet, Nedlands, WA 6009, Australia
[2] Univ Western Australia, Sch Med & Pharmacol, Perth, WA 6009, Australia
[3] Univ Western Australia, Sch Pathol & Lab Med, Perth, WA 6009, Australia
[4] Royal Perth Hosp, Dept Core Clin Pathol & Biochem, Perth, WA, Australia
[5] N Metropolitan Hlth Serv, Area Rehabil & Aged Care, Perth, WA, Australia
[6] Curtin Univ, CBRCC, Perth, WA, Australia
关键词
CHOLECALCIFEROL SUPPLEMENTATION; FALLS; MUSCLE STRENGTH; MOBILITY; OLDER WOMEN; VITAMIN-D; DOUBLE-BLIND; CALCIUM SUPPLEMENTATION; FRACTURES; RISK; MEN; PREVENTION; COMMUNITY; DENSITY;
D O I
10.1002/jbmr.524
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Daily vitamin D in addition to calcium supplementation reduces falls and fractures in older women. However, poor adherence to therapy is a common clinical problem. To examine the effects of supervised oral 3-monthly vitamin D therapy on falls, muscle strength, and mobility, we conducted a 9-month randomized, double-blind, placebo-controlled trial in 686 community-dwelling ambulant women aged over 70 years. Participants received either oral cholecalciferol 150,000 IU every 3 months (n=353) or an identical placebo (n=333). All participants were advised to increase dietary calcium intake. Falls data were collected 3-monthly. At baseline, 3, 6, and 9 months, muscle strength was measured by a handheld dynamometer and mobility by the Timed Up and Go (TUG) test. Serum 25 hydroxyvitamin D (25OHD) was measured in a subgroup of 40 subjects. Mean age at baseline was 76.7 +/- 4.1 years. The average serum 25OHD value at baseline was 65.8 +/- 22.7 nmol/L. By 3, 6, and 9 months after supplementation, 25OHD levels of the vitamin D group were approximately 15?nmol/L higher than the placebo group. Calcium intake did not change significantly between baseline (864 +/- 412 mg/day) and 9 months (855 +/- 357 mg/day). Faller rates in the two groups did not differ: vitamin D group, 102 of 353 (29%); placebo group, 89 of 333 (27%). At 9 months, compared to placebo or baseline, muscle strength, and TUG were not altered by vitamin D. In conclusion, oral cholecalciferol 150,000 IU therapy administered 3-monthly had neither beneficial nor adverse effects on falls or physical function. These data together with previous findings confirm that intermittent large doses of vitamin D are ineffective or have a deleterious effect on falls. Thus despite adherence issues with daily vitamin D replacement, an intermittent, high-dose vitamin D regimen cannot be supported as a strategy to reduce falls and fractures. (C) 2012 American Society for Bone and Mineral Research
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页码:170 / 176
页数:7
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