Larsen Erik Roj, Mosekilde Leif, Foldspang Anders
Department of Orthopaedic Surgery, Randers Central Hospital, Randers, Denmark.
J Bone Miner Res. 2004 Mar;19(3):370-8. doi: 10.1359/JBMR.0301240. Epub 2003 Dec 22.
This study of 9605 community-dwelling residents supports that vitamin D and calcium supplementation may prevent osteoporotic fractures in elderly in a northern European region known to be deficient in vitamin D, especially during winter periods.
We evaluated the effect of two programs for the prevention of osteoporotic fractures leading to acute hospital admission in a population of elderly community-dwelling residents.
This was a factorial, cluster-randomized, pragmatic, intervention study. We included 9605 community-dwelling residents aged 66+ years. We offered a prevention program of a daily supplement of 1000 mg of elemental calcium as calcium carbonate and 400 IU (10 microg) of vitamin D3 to a total of 4957 participants. Another program with evaluation and suggestions for the improvement of the domestic environment was offered to a total of 5063 participants. Both programs included revision of the resident's current pharmaceutical treatment. We achieved information on osteoporotic fractures in the study population from the Danish Hospital Registration Database. We defined osteoporotic fractures as low energy fractures of the proximal humerus, distal forearm, vertebral column, pelvis, cervical femur, and intertrochanteric femur.
Active participation was 50.3% in the Calcium and Vitamin D Program and 46.4% in the Environmental and Health Program. We observed a 16% reduction in fracture incidence rate (relative risk [RR], 0.84; CI, 0.72-0.98; p < 0.025) among male and female residents offered the Calcium and Vitamin D Program (intention-to-prevent analysis).
This study supports that vitamin D and calcium supplementation may prevent osteoporotic fractures in community-dwelling elderly people in a northern European region known to be deficient in vitamin D, especially during winter periods.
这项针对9605名社区居民的研究表明，在北欧一个已知维生素D缺乏的地区，补充维生素D和钙可能预防老年人骨质疏松性骨折，尤其是在冬季。
我们评估了两项预防骨质疏松性骨折导致急性住院的项目对老年社区居民的效果。
这是一项析因、整群随机、务实的干预性研究。我们纳入了9605名66岁及以上的社区居民。我们为总共4957名参与者提供了一项预防项目，即每日补充1000毫克碳酸钙形式的元素钙和400国际单位（10微克）维生素D3。另一项为总共5063名参与者提供的项目包括对家庭环境进行评估并提出改善建议。两项项目均包括对居民当前药物治疗的复查。我们从丹麦医院登记数据库获取了研究人群中骨质疏松性骨折的信息。我们将骨质疏松性骨折定义为肱骨近端、前臂远端、脊柱、骨盆、股骨颈和股骨转子间的低能量骨折。
钙和维生素D项目的积极参与率为50.3%，环境与健康项目的积极参与率为46.4%。在接受钙和维生素D项目的男性和女性居民中（意向性预防分析），我们观察到骨折发生率降低了16%（相对风险[RR]，0.84；置信区间，0.72 - 0.98；p < 0.025）。
这项研究表明，在北欧一个已知维生素D缺乏的地区，补充维生素D和钙可能预防社区居住老年人的骨质疏松性骨折，尤其是在冬季。
