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Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss: A Randomized Controlled Trial
Author(s) -
Aloia John,
Fazzari Melissa,
Islam Shahidul,
Mikhail Mageda,
Shieh Albert,
Katumuluwa Subhashini,
Dhaliwal Ruban,
Stolberg Alexandra,
Usera Gianina,
Ragolia Louis
Publication year - 2018
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.3521
Subject(s) - medicine , parathyroid hormone , vitamin d and neurology , bone mineral , n terminal telopeptide , endocrinology , randomized controlled trial , bone density , vitamin d deficiency , vitamin , bone remodeling , placebo , osteoporosis , alkaline phosphatase , osteocalcin , calcium , chemistry , biochemistry , enzyme , alternative medicine , pathology
Black Americans have lower levels of serum 25(OH)D but superior bone health compared to white Americans. There is controversy over whether they should be screened for vitamin D deficiency and have higher vitamin D requirements than recommended by the Institute of Medicine (IOM). The purpose of this trial was to determine whether Vitamin D supplementation in elderly black women prevents bone loss. A total of 260 healthy black American women, 60 years of age and older were recruited to take part in a two‐arm, double‐dummy 3‐year randomized controlled trial (RCT) of vitamin D 3 versus placebo. The study was conducted in an ambulatory clinical research center. Vitamin D 3 dose was adjusted to maintain serum 25(OH)D above 75 nmol/L. Bone mineral density (BMD) and serum were measured for parathyroid hormone (PTH), C‐terminal crosslink telopeptide (CTX), and bone‐specific alkaline phosphatase (BSAP) every 6 months. Baseline serum 25(OH)D 3 was 54.8 ± 16.8 nmol/L. There was no group × time interaction effect for any BMD measurement. For all BMD measurements, except for total body and spine, there was a statistically significant negative effect of time ( p < 0.001). An equivalency analysis showed that the treatment group was equivalent to the control group. Serum PTH and BSAP declined, with a greater decline of PTH in the treatment group. The rate of bone loss with serum 25(OH)D above 75 nmol/L is comparable to the rate of loss with serum 25(OH)D at the Recommended Dietary Allowance (RDA) of 50 nmol/L. Black Americans should have the same exposure to vitamin D as white Americans. © 2018 American Society for Bone and Mineral Research.