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QJM Advance Access originally published online on March 14, 2006
QJM 2006 99(6):355-363; doi:10.1093/qjmed/hcl031
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reviews

Calcium and vitamin D in the prevention of osteoporotic fractures

R.M. Francis1,, F.H. Anderson2, S. Patel3, O. Sahota4 and T.P. van Staa5

From the 1School of Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, 2Geriatric Medicine Group, University of Southampton, Southampton, 3Department of Rheumatology, St Helier Hospital, Carshalton, 4Department of Health Care of the Elderly, Queen's Medical Centre, University Hospital, Nottingham, UK and 5Procter and Gamble Pharmaceuticals and University of Utrecht, Utrecht, Netherlands

Address correspondence to Professor R.M. Francis, Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN. email: rmfrancis@compuserve.com

The first 150 words of the full text of this article appear below.


   Introduction
 
Osteoporosis has been defined as a skeletal disorder characterized by compromised bone strength, predisposing a person to increased risk of fracture.1 The three major osteoporotic fractures are those of the forearm, vertebra and hip, but fractures of the humerus, pelvis and ribs are also common. The incidence of these fracture rises steeply with age, such that most occur in people aged >65 years, where they are associated with excess mortality, substantial morbidity, and significant health and social services expenditure.2 This paper outlines the physiological roles of calcium and vitamin D, and assesses the current criteria for adequate calcium intake and optimal vitamin D status in adults. It highlights the prevalence of vitamin D insufficiency and low calcium intake in the UK, and reviews studies of vitamin D supplementation, with and without calcium, in the prevention of falls and fractures. Relevant clinical trials were identified using the search strategies described in . . . [Full Text of this Article]


   Functions of calcium
 

   Dietary calcium requirements
 

   Functions of vitamin D
 

   Vitamin D status
 

   Supplementation with calcium and vitamin D, or vitamin D alone
 
Vitamin D alone
Calcium and vitamin D supplementation
Meta-analyses and systematic reviews

   Effect of calcium and vitamin D on falls risk
 
Potential reasons for inconsistent effects of vitamin D on falls and fractures
Adjunctive use of calcium and vitamin D with osteoporosis treatments
Use of calcium and vitamin D in the UK

   Conclusions
 

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[Abstract] [Full Text] [PDF]