Older Persons Health Specialist Service, Canterbury District Health Board, Christchurch 8022, New Zealand ; Department of Medicine, University of Otago, Christchurch 8140, New Zealand.
Biomed Res Int. 2013;2013:463589. doi: 10.1155/2013/463589. Epub 2013 Aug 24.
Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts.
To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers.
We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required.
Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty.
A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.
维生素 D 常用于治疗骨质疏松症。70 岁以上和居住在养老院的人群骨折风险增加。与年轻的社区居住者相比，居住在养老院的老年患者可能具有更多的相似性，他们可能是一个异质群体。
综述适用于≥70 岁社区居住患者或养老院患者的骨化三醇或麦角骨化醇治疗骨质疏松症的证据。其次，终点是骨矿物质密度和骨转换标志物的变化。
我们使用骨质疏松症和维生素 D 的搜索词进行了文献检索。需要至少一年的治疗。
只有一项关于使用骨化三醇的养老院研究表明，维生素 D 缺乏的受试者的非椎体和髋部骨折减少。在社区环境中，一项使用麦角骨化醇的准随机研究表明，全髋部骨折减少，但髋部或非椎体骨折没有减少，另一项随机研究表明髋部骨折风险增加。三项研究报告了髋部骨矿物质密度的增加。
少数研究表明维生素 D 对骨折有益，一项研究表明在社区环境中可能存在危害。目前的做法应该是仅向被确定为缺乏的患者提供这种治疗。
