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Effect of Supplemental Vitamin D3 on Bone Mineral Density: A Systematic Review and Meta-Analysis Publisher Pubmed



Kazemian E1 ; Pourali A2 ; Sedaghat F3 ; Karimi M4 ; Basirat V5 ; Sajadi Hezaveh Z6, 7 ; Davoodi SH7 ; Holick MF8
Authors
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Authors Affiliations
  1. 1. The Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  2. 2. The Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. The Department of Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. The Department of Public Health, Khoy University of Medical Sciences, West Azerbaijan, Khoy, Iran
  5. 5. The Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran
  6. 6. The Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. The Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8. The Section of Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA, United States

Source: Nutrition Reviews Published:2023


Abstract

Context: There is still controversy over the effect of vitamin D3 supplementation on bone health. Objective: The effects of vitamin D3 supplementation on bone mineral density (BMD) and markers of bone turnover, as well as the dose-response relationship between vitamin D3 and bone health in adults, were evaluated. Data Sources: The PubMed, Scopus, Cochrane, Web of Science, and AGRIS databases were searched for articles published through April 30, 2022. Thirty-nine of the 6409 records identified met the inclusion criteria Data Extraction: Data were extracted from articles by 2 authors, and data extraction was cross-checked independently. A random-effects model was used to estimate the pooled effect size and the associated 95%CI for the effect of vitamin D3 for each outcome. A one-stage random-effects dose-response model was used to estimate the dose-response relationship between vitamin D3 supplementation and BMD. Data Analysis: Results of meta-analysis showed a beneficial effect of vitamin D3 at the lumbar spine (standardized mean difference [SMD] = 0.06; 95%CI, 0.01-0.12) and femoral neck (SMD = 0.25; 95%CI, 0.09-0.41). Dose-response analysis revealed a linear relationship between vitamin D3 supplementation doses and BMD at the femoral neck, lumbar spine, and total hip sites. No significant effect of vitamin D3 supplementation on whole-body or total hip BMD was observed (P > 0.05). Vitamin D3 supplementation significantly decreased BMD at both proximal and distal forearm (SMD = -0.16; 95%CI, -0.26 to -0.06). The variables of ethnicity, age, baseline 25-hydroxyvitamin D (25[OH]D), menopause status, vitamin D3 dosing frequency, and bone health status (P interaction = 0.02) altered the effect of vitamin D3 supplementation on BMD. Additionally, a nonlinear relationship between vitamin D3 supplement doses and markers of bone turnover was found. Conclusion: A protective effect of vitamin D3 supplementation on BMD of the lumbar spine, femoral neck, and total hip is implicated. © The Author(s) 2022.
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