Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review

Abstract The present systematic review investigates whether different doses of vitamin D and calcium supplementation in women with postmenopausal osteoporosis undergoing antiresorptive therapy have an association with BMD (spine, hip, femur neck), serum markers of osteoporosis (bone-ALP, NTX, CTX),...

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Main Authors: Filippo Migliorini, Nicola Maffulli, Giorgia Colarossi, Amelia Filippelli, Michael Memminger, Valeria Conti
Format: Article
Language:English
Published: BMC 2025-03-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02412-x
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author Filippo Migliorini
Nicola Maffulli
Giorgia Colarossi
Amelia Filippelli
Michael Memminger
Valeria Conti
author_facet Filippo Migliorini
Nicola Maffulli
Giorgia Colarossi
Amelia Filippelli
Michael Memminger
Valeria Conti
author_sort Filippo Migliorini
collection DOAJ
description Abstract The present systematic review investigates whether different doses of vitamin D and calcium supplementation in women with postmenopausal osteoporosis undergoing antiresorptive therapy have an association with BMD (spine, hip, femur neck), serum markers of osteoporosis (bone-ALP, NTX, CTX), the rate of pathological vertebral and non-vertebral fractures, adverse events, and mortality. This systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Scopus databases were accessed in September 2024. All randomised clinical trials (RCTs) comparing two or more treatments for postmenopausal osteoporosis supplemented with vitamin D and/or calcium were accessed. Only studies that indicated daily vitamin D and/or calcium supplementation doses were accessed. Data from 37 RCTs (43,397 patients) were retrieved. Patients received a mean of 833.6 ± 224.0 mg and 92.8 ± 228.7 UI of calcium and vitamin D supplementation, respectively. The mean length of the follow-up was 25.8 ± 13.3 months. The mean age of the patients was 66.4 ± 5.6 years, and the mean BMI was 25.2 ± 1.6 kg/m2. There was evidence of a statistically significant negative association between daily vitamin D supplementation and gastrointestinal adverse events (r = − 0.5; P = 0.02) and mortality (r = − 0.7; P = 0.03). No additional statistically significant associations were evidenced. In postmenopausal women who undergo antiresorptive treatment for osteoporosis, vitamin D was associated with a lower frequency of gastrointestinal adverse events and mortality. Calcium supplementation did not evidence an association with any of the endpoints of interest. Level of evidence Level I, systematic review of RCTs.
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spelling doaj-art-23081ab8e9af433b95dcfc71a5bdf83d2025-08-20T02:56:19ZengBMCEuropean Journal of Medical Research2047-783X2025-03-0130111110.1186/s40001-025-02412-xVitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic reviewFilippo Migliorini0Nicola Maffulli1Giorgia Colarossi2Amelia Filippelli3Michael Memminger4Valeria Conti5Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, RWTH University Medical CentreDepartment of Medicine and Psychology, University La SapienzaDepartment of Medicine, Academic Hospital of WürselenClinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni Di Dio E Ruggi d’Aragona”Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA)Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni Di Dio E Ruggi d’Aragona”Abstract The present systematic review investigates whether different doses of vitamin D and calcium supplementation in women with postmenopausal osteoporosis undergoing antiresorptive therapy have an association with BMD (spine, hip, femur neck), serum markers of osteoporosis (bone-ALP, NTX, CTX), the rate of pathological vertebral and non-vertebral fractures, adverse events, and mortality. This systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Scopus databases were accessed in September 2024. All randomised clinical trials (RCTs) comparing two or more treatments for postmenopausal osteoporosis supplemented with vitamin D and/or calcium were accessed. Only studies that indicated daily vitamin D and/or calcium supplementation doses were accessed. Data from 37 RCTs (43,397 patients) were retrieved. Patients received a mean of 833.6 ± 224.0 mg and 92.8 ± 228.7 UI of calcium and vitamin D supplementation, respectively. The mean length of the follow-up was 25.8 ± 13.3 months. The mean age of the patients was 66.4 ± 5.6 years, and the mean BMI was 25.2 ± 1.6 kg/m2. There was evidence of a statistically significant negative association between daily vitamin D supplementation and gastrointestinal adverse events (r = − 0.5; P = 0.02) and mortality (r = − 0.7; P = 0.03). No additional statistically significant associations were evidenced. In postmenopausal women who undergo antiresorptive treatment for osteoporosis, vitamin D was associated with a lower frequency of gastrointestinal adverse events and mortality. Calcium supplementation did not evidence an association with any of the endpoints of interest. Level of evidence Level I, systematic review of RCTs.https://doi.org/10.1186/s40001-025-02412-xOsteoporosisPostmenopausalVitamin DCalciumSupplementation
spellingShingle Filippo Migliorini
Nicola Maffulli
Giorgia Colarossi
Amelia Filippelli
Michael Memminger
Valeria Conti
Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
European Journal of Medical Research
Osteoporosis
Postmenopausal
Vitamin D
Calcium
Supplementation
title Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
title_full Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
title_fullStr Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
title_full_unstemmed Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
title_short Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review
title_sort vitamin d and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis a level i of evidence systematic review
topic Osteoporosis
Postmenopausal
Vitamin D
Calcium
Supplementation
url https://doi.org/10.1186/s40001-025-02412-x
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