The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials
Abstract
PURPOSE: This systematic review and meta-analysis assesses the efficacy of combined calcium and vitamin D supplementation on bone mineral density (BMD) and fracture risk among postmenopausal women with osteoporosis. METHODS: We conducted a comprehensive search across multiple medical databases including PubMed, Embase, Cochrane Library, and Web of Science, collecting randomized controlled trials (RCTs) published from database inception to present. Data extraction and analysis were performed to calculate standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs), which were then presented in forest plots. RESULTS: Eleven RCTs with 43,869 participants were included. Combined supplementation modestly improved BMD at the pelvis (SMD = 0.20, 95% CI: 0.05–0.35, p = 0.01) without significant changes in BMD at the lumbar spine, femoral neck, or total hip. The overall fracture risk was not significantly reduced (RR = 0.98, 95% CI: 0.89–1.07, p = 0.68). Subgroup analyses revealed improvements in serum 25‑hydroxyvitamin D levels (25OHD), especially in participants with baseline deficiencies (Z = 10.48, p 42 000 participants) yielded a neutral effect on any clinical fracture (pooled RR = 0.95; 95% CI 0.85–1.07; Z = 1.08, P = 0.28; I² = 0%). Sensitivity analyses affirmed the findings’ stability, with no evident publication bias. CONCLUSION: Combined calcium and vitamin D supplementation may improve pelvic BMD and correct serum 25OHD deficiencies in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 43,869 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.