F. Y. EYE

The data from studies regarding efficacy of vitamin D supplementation for fracture reduction have shown conflicting results. To provide further evidence regarding whether vitamin D is beneficial in fracture reduction, researchers conducted an ancillary study in the Vitamin D and Omega=3 Trial (VITAL). There were 25 781 individuals enrolled and randomly assigned to placebo or vitamin D up to 800 IU per day in conjunction with at least 1200 mg of calcium. Participants were followed up for a median of 5.3 years, with fracture occurrence determined by patient questionnaire and a centralized medical records review. An intent-to-treat analysis using proportional hazards models was conducted, and subgroup analysis was stratified by baseline 25-hydroyvitamin D levels. Over the course of the study, there were 1991 fractures in 1551 participants and the data analysis found there was no benefit in fracture reduction from vitamin D supplementation, even for participants who had initial levels below 20 ng/ml. Of the total fractures, 769 occurred in 12 927 participants in the vitamin D group, and 782 of fractures occurred in the 12 944 controls (0.98 hazard ratio, 95% confidence interval 0.89 to 1.08, p=0.7). There was no significant effect of vitamin D supplementation for the occurrence of nonvertebral fractures (p=0.5) or hip fractures (p=0.96). The authors concluded that vitamin D supplementation did not result in a lower risk of fractures.LeBoff M, Chou S, Ratliff K et al. Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults. N Engl J Med 2022; 387:299-309. DOI: 10.1056/NEJMoa2202106