Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 97, Issue 2, Pages 614-622Publisher
ENDOCRINE SOC
DOI: 10.1210/jc.2011-1309
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Funding
- United Kingdom Medical Research Council [G9706483]
- Shire Pharmaceuticals Group plc
- Chief Scientist Office of the Scottish Government Health Directorates
- Cancer Research UK [14136] Funding Source: researchfish
- Chief Scientist Office [HSRU1] Funding Source: researchfish
- Medical Research Council [MC_U147585824, MC_UP_A620_1014, U1475000001, G1000143, G0401527] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10082] Funding Source: researchfish
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Context: Vitamin D or calcium supplementation may have effects on vascular disease and cancer. Objective: Our objective was to investigate whether vitamin D or calcium supplementation affects mortality, vascular disease, and cancer in older people. Design and Setting: The study included long-term follow-up of participants in a two by two factorial, randomized controlled trial from 21 orthopedic centers in the United Kingdom. Participants: Participants were 5292 people (85% women) aged at least 70 yr with previous low-trauma fracture. Interventions: Participants were randomly allocated to daily vitamin D-3 (800 IU), calcium (1000 mg), both, or placebo for 24-62 months, with a follow-up of 3 yr after intervention. Main Outcome Measures: All-cause mortality, vascular disease mortality, cancer mortality, and cancer incidence were evaluated. Results: In intention-to-treat analyses, mortality [hazard ratio (HR) = 0.93; 95% confidence interval (CI) = 0.85-1.02], vascular disease mortality (HR = 0.91; 95% CI = 0.79-1.05), cancer mortality (HR = 0.85; 95% CI = 0.68-1.06), and cancer incidence (HR = 1.07; 95% CI = 0.92-1.25) did not differ significantly between participants allocated vitamin D and those not. All-cause mortality (HR = 1.03; 95% CI = 0.94-1.13), vascular disease mortality (HR = 1.07; 95% CI = 0.92-1.24), cancer mortality (HR = 1.13; 95% CI = 0.91-1.40), and cancer incidence (HR = 1.06; 95% CI = 0.91-1.23) also did not differ significantly between participants allocated calcium and those not. In a post hoc statistical analysis adjusting for compliance, thus with fewer participants, trends for reduced mortality with vitamin D and increased mortality with calcium were accentuated, although all results remain nonsignificant. Conclusions: Daily vitamin D or calcium supplementation did not affect mortality, vascular disease, cancer mortality, or cancer incidence. (J Clin Endocrinol Metab 97: 614-622, 2012)
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