scholarly journals Clinical practice: the place of calcium supplements and vitamin D in the treatment of osteoporosis

Author(s):  
О.В. Добровольская ◽  
Н.В. Торопцова

Целью данного исследования было оценить место комбинированных препаратов кальция и витамина D в структуре лечения женщин в постменопаузе с остеопорозом, осложненным низкоэнергетическим переломом, и приверженность к ним в реальной клинической практике. Проанкетированы 196 женщин в постменопаузе (средний возраст 65,8 ± 9,1 года), перенесших низкоэнергетические переломы различных локализаций. Оценка структуры противоостеопоротической терапии и приверженности к лечению осуществлялась в течение 3 месяцев после перелома. 61%, 62%, 58% и 42% женщин получали противоостеопоротическую терапию через 4 месяца, 1, 2 и 3 года после перелома соответственно. Среди них только препаратами кальция и витамина D лечились 46%, 38%, 34% и 19% опрошенных соответственно. 49% респонденток, не получавших лечения по поводу остеопороза, в качестве причины указали отсутствие рекомендаций лечащего врача. Приверженными к приему препаратов кальция и витамина D в течение 1, 2 и 3 лет после перелома были 44%, 30% и 17% пациенток соответственно. Наиболее приверженными к лечению были лица, проконсультированные в специализированном центре по остеопорозу. Результаты исследования свидетельствуют о том, что женщинам после произошедшего перелома препараты кальция и витамина D назначались значимо чаще, чем патогенетические противоостеопоротические лекарственные средства. С увеличением срока после произошедшего перелома отмечалось снижение приверженности к приему кальция и витамина D, что демонстрирует необходимость более активного разъяснения пациенткам целесообразности длительного противоостеопоротического лечения, включая прием кальция и витамина D. The aim of this study was to assess the place of combined calcium and vitamin D preparations in the structure of treatment of postmenopausal women with osteoporosis complicated by low-energy fracture, and adherence to them in real clinical practice. A total of 196 postmenopausal women (mean age 65.8 ± 9.1 years) who had undergone low-energy fractures of various localizations were questioned. The structure of anti-osteoporotic therapy and adherence to treatment were assessed within 3 months after the fracture. 61%, 62%, 58% and 42% of women received anti-osteoporotic therapy at 4 months, 1, 2 and 3 years after the fracture, respectively. Among them, only calcium and vitamin D preparations were treated by 46%, 38%, 34% and 19% of the respondents, respectively. 49% of respondents who did not receive treatment for osteoporosis indicated the absence of recommendations from their doctor as the reason. Adherents to calcium and vitamin D supplementation for 1, 2 and 3 years after fracture were 44%, 30% and 17% of patients, respectively. The most adherent to treatment were those consulted at a specialized osteoporosis center. The results of the study indicate that after a fracture occurred to women, calcium and vitamin D preparations were prescribed significantly more often than pathogenetic anti-osteoporotic drugs. With an increase in the period after the fracture occurred, a decrease in adherence to calcium and vitamin D intake was noted, which demonstrates the need for a more active explanation to patients of the advisability of long-term anti-osteoporotic treatment, including calcium and vitamin D intake.

2010 ◽  
Vol 71 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Kathryn L. Hall ◽  
Caroline E. Denda ◽  
Helen Yeung

Purpose: Dietary vitamin D intake was assessed among residents in a long-term care (LTC) facility, so that recommendations could be made about vitamin D supplementation. Methods: Three-day tray audits were completed for allmeals and snacks, including nutritional supplements (Boost™and/or high-protein pudding). Total daily and three-day vitamin D intake was calculated for each resident, and the total sample was compared with the recommended Adequate Intake (AI) of 600 IU. Vitamin D content was calculated using the Canadian Nutrient File and product labels. Resident charts were reviewed for micronutrient supplements and diagnoses. Results: The daily average vitamin D available to and consumed by 30 residents was 414 IU and 295 IU, respectively. Those provided with nutritional supplements received an average of 480 IU and consumed 357 IU, while those without received an average of 245 IU and consumed 207 IU. Thirty-three percent of residents were diagnosed with osteoporosis, osteoarthritis, and falls and/or fractures. Vitamin Dmicronutrient supplementation varied from above 600 IU (43%) to below 600 IU (30%) to no supplementation (27%). Conclusions:None of the study participantsmet the recommended AI of 600 IU through dietary sources alone. Study results suggest that all LTC residents require vitamin Dmicronutrient supplementation of at least 400 IU to achieve the recommended AI of 600 IU.


2021 ◽  
Vol 13 ◽  
pp. 1759720X2110069
Author(s):  
Rebecca J. Moon ◽  
Elizabeth M. Curtis ◽  
Stephen J. Woolford ◽  
Shanze Ashai ◽  
Cyrus Cooper ◽  
...  

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.


Author(s):  
Matthew F Warren ◽  
Kimberly A Livingston

Abstract The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview with how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism. However, there is much more that can be understood with VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms which could lead to newer insights with VDR. Utilizing chickens in future research to help with elucidating vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus 2019 disease (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added value with possibly leading to vitamin D-enriched meat and egg products; and 2) chickens’ use in research provides data for translational research. Expanding vitamin D-related research in chickens to include more nutritional aims in vitamin D status has great implications with developing better strategies to improve human health.


2021 ◽  
pp. jim-2020-001645
Author(s):  
Laura D Carbone ◽  
Karen Johnson ◽  
Joseph C Larson ◽  
Fridtjof Thomas ◽  
Jean Wactawski-Wende ◽  
...  

The relationship between vitamin D and glaucoma is controversial. The objective of this study was to examine women from the Women’s Health Initiative (WHI) to determine if there is an association between vitamin D and incident glaucoma in postmenopausal women. We examined the association between dietary vitamin D intake, vitamin D supplements and serum 25 hydroxyvitamin D (25(OH)D) levels and the risk of developing glaucoma. 143,389 postmenopausal women from the WHI including a subset with serum 25(OH) D measurements were examined to determine the association of dietary, supplemental and serum levels of vitamin D to the development of glaucoma. Dietary intakes of vitamin D, use of vitamin D supplements and serum levels of 25(OH) D were predictors examined for the main outcome of incident glaucoma. In multivariable models adjusted for demographic, clinical variables and medication use, dietary vitamin D, vitamin D supplements, total vitamin D intake (diet plus supplements) and serum 25 (OH) D measurements were not significantly associated with incident glaucoma. In the CaD placebo-controlled intervention clinical trial, there was also no association in the active intervention arm with glaucoma. We conclude that dietary vitamin D intake, supplements and serum levels are not significantly related to the risk of developing glaucoma in postmenopausal women.


Aging Health ◽  
2006 ◽  
Vol 2 (2) ◽  
pp. 241-243
Author(s):  
Philip E Lee ◽  
Janet E McElhaney ◽  
Larry Dian

Sign in / Sign up

Export Citation Format

Share Document