nach oben

Osteoporosis International

Erschienen in:

01.04.2007 | Review

How to select the doses of vitamin D in the management of osteoporosis

verfasst von: H. A. Bischoff-Ferrari

Erschienen in: Osteoporosis International | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

The dose of vitamin D in the management of osteoporosis should be no less than 700–800 IU per day. An optimal dose of vitamin D should raise serum concentrations of 25(OH)D to the desirable range of at least 75 nmol/l. Higher intermittent oral doses of vitamin D may overcome low adherence. Vitamin D supplementation in the management of osteoporosis holds a significant public health potential because of its low cost, excellent tolerability, and combined musculo-skeletal benefits. Fall and fracture prevention with vitamin D is especially appealing in the treatment of older individuals at risk for fall-related fractures. However, bone density, strength, and function benefits with vitamin D include active and inactive subgroups of community-dwelling older men and women. Based on a recent expert panel and supportive evidence presented in this review, serum concentrations of at least 75 nmol/l 25(OH)D will be referred to as desirable. Today, desirable serum 25(OH)D levels of at least 75 nmol/l may only be reached in about one third of US older individuals and even fewer European older individuals. Two main factors discussed in this review may help public health efforts to ensure desirable vitamin D levels for fall and fracture prevention, including (1) a sufficient dose of vitamin D and (2) improved adherence to supplementation.

Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16(7):713–716, Epub Mar 18PubMedCrossRef

Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293(18):2257–2264PubMedCrossRef

Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B (2004) Positive association between 25-hydroxy vitamin d levels and bone mineral density: a population-based study of younger and older adults. Am J Med 116(9):634–639PubMedCrossRef

Bischoff-Ferrari HA, Dietrich T, Orav EJ et al (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged >= 60 years. Am J Clin Nutr 80(3):752–758PubMed

Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW et al (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291(16):1999–2006PubMedCrossRef

Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 15(6):1113–1118PubMedCrossRef

Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18(2):343–351PubMedCrossRef

Gallagher JC, Fowler SE, Detter JR, Sherman SS (2001) Combination treatment with estrogen and calcitriol in the prevention of age-related bone loss. J Clin Endocrinol Metab 86(8):3618–3628PubMedCrossRef

Dukas L, Bischoff HA, Lindpaintner LS et al (2004) Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily. J Am Geriatr Soc 52(2):230–236PubMedCrossRef

10.

Graafmans WC, Ooms ME, Hofstee HM, Bezemer PD, Bouter LM, Lips P (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 143(11):1129–1136PubMed

11.

Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166(4):424–430PubMedCrossRef

12.

Flicker L, MacInnis RJ, Stein MS et al (2005) Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc 53(11):1881–1888PubMedCrossRef

13.

Grant AM, Avenell A, Campbell MK et al (2005) Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 365(9471):1621–1628PubMedCrossRef

14.

Jackson RD, LaCroix AZ, Gass M et al (2006) Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354(7):669–683PubMedCrossRef

15.

Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF (1999) An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int 9(5):394–397PubMedCrossRef

16.

Tangpricha V, Pearce EN, Chen TC, Holick MF (2002) Vitamin D insufficiency among free-living healthy young adults. Am J Med 112:659–662PubMedCrossRef

17.

Barger-Lux MJ, Heaney RP, Dowell S, Chen TC, Holick MF (1998) Vitamin D and its major metabolites: serum levels after graded oral dosing in healthy men. Osteoporos Int 8(3):222–230PubMedCrossRef

18.

Dawson-Hughes B (2002) Impact of vitamin D and calcium on bone and mineral metabolism in older adults. In: Holick MF (ed) Biologic effects of light 2001. Kluwer Academic Publishers, Boston, MA, pp 175–183

19.

Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77(1):204–210PubMed

20.

Vieth R, Chan PC, MacFarlane GD (2001) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 73(2):288–294PubMed

21.

Heaney RP (2005) The Vitamin D requirement in health and disease. J Steroid Biochem Mol Biol 15:15

22.

Yates AA (1998) Process and development of dietary reference intakes: basis, need, and application of recommended dietary allowances. Nutr Rev 56(4 Pt 2):S5–S9PubMed

23.

Intakes SCotSEoDR (1997) Dietary reference intakes: calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy Press, Washington, DC

24.

Haddock L, Corcino J, Vazquez MD (1982) 25(OH)D serum levels in the normal Puerto Rican population and in subjects with tropical sprue and paratyroid disease. Puerto Rico Health Sci J 1:85–91

25.

Haddad JG, Chyu KJ (1971) Competitive protein-binding radioassay for 25-hydroxycholecalciferol. J Clin Endocrinol Metab 33(6):992–995PubMedCrossRef

26.

Gertner JM, Domenech M (1977) 25-hydroxyvitamin D levels in patients treated with high-dosage ergo- and cholecalciferol. J Clin Pathol 30(2):144–150PubMedCrossRef

27.

Vieth R (1999) Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 69(5):842–856PubMed

28.

Dawson-Hughes B, Harris SS, Dallal GE (1997) Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 65(1):67–71PubMed

29.

Grant WB, Holick MF (2005) Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10(2):94–111PubMed

30.

McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93(1):69–77PubMedCrossRef

31.

Theiler R, Stahelin HB, Kranzlin M et al (2000) Influence of physical mobility and season on 25-hydroxyvitamin D-parathyroid hormone interaction and bone remodelling in the elderly. Eur J Endocrinol 143(5):673–679PubMedCrossRef

32.

Holick MF (1995) Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 61(suppl):638S–645SPubMed

33.

Heikinheimo RJ, Inkovaara JA, Harju EJ et al (1992) Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 51(2):105–110PubMedCrossRef

34.

Heikinheimo RJ, Haavisto MV, Harju EJ et al (1991) Serum vitamin D level after an annual intramuscular injection of ergocalciferol. Calcif Tissue Int 49(Suppl):S87PubMedCrossRef

35.

Anderson FH, Smith HE, Raphael HM, Crozier SR, Cooper C (2004) Effect of annual intramuscular vitamin D3 supplementation on fracture risk in 9440 community-living older people: the Wessesx Fracture Prevention Trial. JBMR 19(Suppl. 1) Abstract 1220

36.

Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM (1996) Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med 124(4):400–406PubMed

37.

Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI (2002) Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17(4):709–715PubMedCrossRef

38.

Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. Bmj 326(7387):469PubMedCrossRef

39.

Khaw KT, Scragg R, Murphy S (1994) Single-dose cholecalciferol suppresses the winter increase in parathyroid hormone concentrations in healthy older men and women: a randomized trial. Am J Clin Nutr 59(5):1040–1044PubMed

40.

Holick MF, Matsuoka LY, Wortsman J (1989) Age, vitamin D, and solar ultraviolet. Lancet 2(8671):1104–1105PubMedCrossRef

41.

MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76(4):1536–1538PubMedCrossRef

42.

Chel VG, Ooms ME, Popp-Snijders C et al (1998) Ultraviolet irradiation corrects vitamin D deficiency and suppresses secondary hyperparathyroidism in the elderly. J Bone Miner Res 13(8):1238–1242PubMedCrossRef

43.

Lim HW, Gilchrest BA, Cooper KD et al (2005) Sunlight, tanning booths, and vitamin D. J Am Acad Dermatol 52(5):868–876PubMedCrossRef

44.

Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS (2003) Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 41(1):1–12PubMedCrossRef

45.

Looker AC, Harris TB, Madans JH, Sempos CT (1993) Dietary calcium and hip fracture risk: the NHANES I Epidemiologic Follow-Up Study. Osteoporos Int 3(4):177–184PubMedCrossRef

46.

Porthouse J, Cockayne S, King C et al (2005) Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 330(7498):1003PubMedCrossRef

47.

Boonen S, Bouillon R, Vanderschueren D, Haentjens P, Lips P (2006) Evidence for hip fracture risk reduction with calcium and vitamin D from a comparative meta-analysis of randomized controlled trials including RECORD and WHI. J Bone Miner Res 21 [Suppl 1]; Abstract 1226(September):S60

48.

Avenell A, Gillespie WJ, Gillespie LD, O’Connell DL (2005) Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev 3:CD000227PubMed

49.

Heaney RP, Dowell MS, Hale CA, Bendich A (2003) Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22(2):142–146PubMed

50.

Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. Jama 294(18):2336–2341PubMedCrossRef

51.

Rizzoli R, Eisman JA, Norquist J et al (2006) Risk factors for vitamin D inadequacy among women with osteoporosis: an international epidemiological study. Int J Clin Pract 60(8):1013–1019PubMedCrossRef

52.

Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30(5):771–777PubMedCrossRef

53.

Theiler R, Stahelin HB, Tyndall A, Binder K, Somorjai G, Bischoff HA (1999) Calcidiol, calcitriol and parathyroid hormone serum concentrations in institutionalized and ambulatory elderly in Switzerland. Int J Vitam Nutr Res 69(2):96–105PubMedCrossRef

54.

Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67(2):373–378PubMedCrossRef

55.

Parikh SJ, Edelman M, Uwaifo GI et al (2004) The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 89(3):1196–1199PubMedCrossRef

56.

Nesby-O’Dell S, Scanlon KS, Cogswell ME et al (2002) Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 76(1):187–192PubMed

57.

Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327(23):1637–1642PubMedCrossRef

Titel: How to select the doses of vitamin D in the management of osteoporosis
verfasst von: H. A. Bischoff-Ferrari
Publikationsdatum: 01.04.2007
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 4/2007
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-006-0293-9

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2007

Acknowledgement of Referees

Integrated anti-remodeling and anabolic therapy for the osteoporosis of Hajdu-Cheney syndrome

A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial

Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se?

Bone loss in elderly men: increased endosteal bone loss and stable periosteal apposition. The prospective MINOS study