Effect of Vitamin D3, Omega-3 Fatty Acids, and Exercise on Serum Sclerostin Levels and Bone Turnover Markers
Abstract
CONTEXT: Sclerostin inhibits canonical Wnt signaling, a pathway promoting bone formation. The effects of vitamin D3, omega-3 fatty acids (omega-3s), and exercise on serum sclerostin levels and bone metabolism are unclear.
OBJECTIVE: To investigate the effects of 2000 IU/day vitamin D3, 1 g/day omega-3s, and a simple home-based strength exercise program (SHEP), alone or in combination, on serum sclerostin and bone turnover marker levels.
METHODS: Sclerostin, procollagen type 1 N propeptide (P1NP) and C-terminal telopeptide (β-CTx) levels were predefined secondary outcomes of DO-HEALTH, a double blind, randomized controlled trial in healthy physically active older adults in 5 European countries. Outcome measures were changes in yearly serum sclerostin, P1NP, and β-CTx levels over 3 years, adjusted for age, sex, prior falls, study site, baseline body mass index, and baseline level of the respective outcome.
RESULTS: A total of 1848 participants were included (mean age 74.8 ± 4.4 years, 58.9% women, 41.4% 25(OH)D < 20 ng/mL, 83.9% at least moderately physically active at baseline). Vitamin D3 and omega-3s supplementation alone did not change sclerostin levels significantly, while SHEP compared with control exercise (joint mobility) led to greater decrease in sclerostin levels (-1.56 pmol/L [-2.54, -0.58], P = .002). Omega-3s plus SHEP led to a greater decrease in sclerostin levels than no omega-3s/control exercise (-1.93 pmol/L [-3.31, -0.54], P = .007). For P1NP and β-CTx there…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,848 participants or records.
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