Is vitamin-D supplementation not useful in patients at risk of fractures and falls?

Abstract

To evaluate numerous publications that question the bone and extraosseous benefits of vitamin D diet supplementation based on results, which often transcend to public opinion, but are not well interpreted. This may have negative consequences on compliance of patients under vitamin D supplementation. Critical appraisal of several articles on vitamin D supplementation and its relationship with fractures, falls, cardiovascular diseases, and cancer incidence. Such publications have certain limitations (i.e. patients excluded because of a diagnosis of osteoporosis, or at a higher risk for fractures and falls, or because they have a vitamin D deficiency, etc.), and conclusions and/or subsequent recommendations should be approached with caution. Our research shows that patients with osteoporosis, vitamin D deficiency, and at high risk of fractures and falls should not discontinue vitamin D supplementation (often associated with calcium). It is becoming increasingly evident that patients with hypovitaminosis D are those that gain a maximal benefit from vitamin D supplementation.

摘要

评估众多基于结果质疑维生素D饮食补充剂的骨骼和骨外益处的出版物, 这些结果往往超越了公众舆论, 但没有得到很好的解读。这可能会对服用维生素D的患者的依从性产生负面影响。对几篇关于维生素D补充剂及其与骨折、跌倒、心血管疾病和癌症发病率的关系的文章进行批判性评价。这类出版物有一定的局限性(即, 由于诊断为骨质疏松症、骨折和跌倒的风险较高、或因为缺乏维生素D等原因而被排除在外的患者), 结论和/或后续建议应谨慎对待。我们的研究表明, 患有骨质疏松症、维生素D缺乏、骨折和跌倒风险较高的患者不应停止补充维生素D(通常与钙有关)。越来越明显的是, 维生素D缺乏症患者是那些从补充维生素D中获得最大好处的人。

Keywords:

• Risk of fractures
• risk of falls
• vitamin-D supplementation

Disclosure statement

Dr. Javier Aguilar reports grants and personal fees as speaker, member of advisory boards, and/or consultant with FAES, Gebro, Amgen, and Lilly.

Dr. Esteban Jodar reports grants and personal fees as consultant and/or speaker from Amgen, AstraZeneca, Boehringer Ingelheim, FAES, Fresenius, Janssen, Lilly, MSD, Novartis, Novo Nordisk, Pfizer, Sanofi, Shire, and UCB.

Dr Rafael Sánchez-Borrego had a financial relationship (lecturer, member of advisory boards, and/or consultant) with 100% Natural, SEID, Shionogi, FAES, Lacer, and AC Mylan.

Dr. Julian Segura had a financial relationship (lecturer, member of advisory boards, and/or consultant) with AstraZeneca, Medtronic, and Pfizer.

Dra. Fátima Brañas has received honoraria for advisory board membership from FAES Pharma.

Dr. Yago González-Lama has received honoraria for advisory board membership from FAES Pharma.

Dr. Jorge Malouf had a financial relationship (lecturer, member of advisory boards, and/or consultant) with Gruenenthal, Esteve, AMGEN, and Lilly.

Dr. Carlos Gómez has received grants and personal fees as consultant and/or speaker from Amgen, Kiowa-Kirin, Italfármaco, FAES, Lilly, UCB, and Gebro.

Dr. Jorge Alonso has no conflict of interest.

Dr. Carmen Valdés has no conflict of interest.