Prescrire Int. 2013 Jun;22(139):152-3.
Adequate dietary calcium intake and appropriate sunlight exposure ensuring adequate vitamin D availability are basic measures for the prevention of osteoporosis. Calcium and vitamin D supplementation increases bone density. Vitamin D plus calcium supplementation prevents hip fractures and other nonvertebral fractures in institutionalised persons 70 years of age or older. A meta-analysis of clinical trials showed an increase in myocardial infarction in patients taking calcium supplementation alone, with a relative risk of about 1.3. Epidemiological studies have not shown an increase in the cardiovascular risk. Conflicting results have also been reported in postmenopausal women taking both calcium and vitamin D. In an epidemiological study, hypercalcaemia was associated with increased mortality, particularly cardiovascular mortality. In practice, caution dictates that not all patients should routinely take calcium and vitamin D supplements. When calcium supplements are nonetheless used, the dose should be adjusted to dietary intake in order to avoid hypercalcaemia.
充足的膳食钙摄入量以及适当的阳光照射以确保充足的维生素D供应是预防骨质疏松症的基本措施。补充钙和维生素D可增加骨密度。维生素D加钙补充剂可预防70岁及以上机构养老人员的髋部骨折和其他非椎骨骨折。一项临床试验的荟萃分析显示，单独服用钙补充剂的患者心肌梗死风险增加，相对风险约为1.3。流行病学研究未显示心血管风险增加。在同时服用钙和维生素D的绝经后女性中也报告了相互矛盾的结果。在一项流行病学研究中，高钙血症与死亡率增加相关，尤其是心血管死亡率。实际上，谨慎起见，并非所有患者都应常规服用钙和维生素D补充剂。尽管如此，当使用钙补充剂时，应根据膳食摄入量调整剂量，以避免高钙血症。
