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Vitamin D with Calcium Reduces Mortality: Patient Level Pooled Analysis of 70,528 Patients from Eight Major Vitamin D Trials

Lookup NU author(s): Emeritus Professor Roger Francis

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Abstract

Introduction: Vitamin D may affect multiple health outcomes. If so, an effect on mortality is to be expected. Using pooled data from randomized controlled trials, we performed individual patient data (IPD) and trial level meta-analyses to assess mortality among participants randomized to either vitamin D alone or vitamin D with calcium. Subjects and Methods: Through a systematic literature search, we identified 24 randomized controlled trials reporting data on mortality in which vitamin D was given either alone or with calcium. From a total of 13 trials with more than 1000 participants each, eight trials were included in our IPD analysis. Using a stratified Cox regression model, we calculated risk of death during 3 yr of treatment in an intention-to-treat analysis. Also, we performed a trial level meta-analysis including data from all studies. Results: The IPD analysis yielded data on 70,528 randomized participants (86.8% females) with a median age of 70 (interquartile range, 62-77) yr. Vitamin D with or without calcium reduced mortality by 7% [ hazard ratio, 0.93; 95% confidence interval (CI), 0.88-0.99]. However, vitamin D alone did not affect mortality, but risk of death was reduced if vitamin D was given with calcium (hazard ratio, 0.91; 95% CI, 0.84-0.98). The number needed to treat with vitamin D plus calcium for 3 yr to prevent one death was 151. Trial level meta-analysis (24 trials with 88,097 participants) showed similar results, i.e. mortality was reduced with vitamin D plus calcium (odds ratio, 0.94; 95% CI, 0.88-0.99), but not with vitamin D alone (odds ratio, 0.98; 95% CI, 0.91-1.06). Conclusion: Vitamin D with calcium reduces mortality in the elderly, whereas available data do not support an effect of vitamin D alone. (J Clin Endocrinol Metab 97: 2670-2681, 2012)


Publication metadata

Author(s): Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, Salovaara K, Cooper C, Smith HE, Jacobs ET, Torgerson D, Jackson RD, Manson JE, Brixen K, Mosekilde L, Robbins JA, Francis RM, Abrahamsen B

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Endocrinology and Metabolism

Year: 2012

Volume: 97

Issue: 8

Pages: 2670-2681

Print publication date: 17/05/2012

ISSN (print): 0021-972X

ISSN (electronic): 1945-7197

Publisher: The Endocrine Society

URL: http://dx.doi.org/10.1210/jc.2011-3328

DOI: 10.1210/jc.2011-3328


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Funding

Funder referenceFunder name
Amgen
Bristol-Myers Squibb
Eli Lilly
Furst Medisinsk Laboratorium
MSD
National Health and Medical Research Council, Australia
National Institutes of Health
Pharmacy Association of 1991
Roche
Shire
Strakan Pharmaceuticals
Australian Commonwealth Department of Health and Ageing
Chief Scientist Office of the Scottish Government Health Directorates
Danish Osteoporosis Association
Municipality of the City of Randers, Randers Central Hospital, Aarhus County, Denmark
Novartis
Nycomed
Servier
UK Medical Research Council
09-070940Danish Council for Independent Research in Medical Sciences
24152National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32100-2National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32105-6National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32108-9National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32118-32119National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32122National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
42107-26National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
42129-32National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
44221National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32111-13National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
32115National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services
N01WH22110National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services

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