Greater BMD loss for women vs. men with high-dose vs. low-dose vitamin D supplementation
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Women with sufficient vitamin D levels at baseline experienced greater bone mineral density loss than men after 3 years of high-dose vs. low-dose vitamin D supplementation, according to an analysis of data from the Calgary Vitamin D Study.
“Over 3 years, high-dose vitamin D supplementation did not improve volumetric bone density or bone strength in healthy community-dwelling adults with normal bone density and adequate levels of vitamin D at study initiation,” Lauren Burt, PhD, senior scientist at McCaig Institute for Bone and Joint Health at the University of Calgary, Steven K. Boyd, PhD, director of McCaig Institute, and David A. Hanley, MD, FRCPC, professor in the departments of medicine, oncology and community health sciences at the University of Calgary, told Healio. “In this secondary analysis of the data, we found vitamin D at a dose of 4,000 IU or 10,000 IU per day, compared with 400 IU per day, resulted in greater losses of volumetric BMD in females. However, in males, there was no dose-response effect of vitamin D supplementation on volumetric BMD.”
Researchers conducted a 3-year randomized, double-blind clinical trial with healthy men and women aged 55 to 70 years (n = 311, 53% men). Participants were randomly assigned to 400 IU (61 men; 48 women), 4,000 IU (51 men; 49 women) or 10,000 IU (53 men; 49 women) vitamin D3 cholecalciferol oral drops. Total volumetric BMD was measured at the radius and tibia using a high-resolution peripheral quantitative CT at baseline and 6, 12, 24 and 36 months.
At the radius, the 10,000 IU group had the greatest total volumetric BMD loss across both sexes, followed by the 4,000 IU group and the 400 IU group. However, women in all three groups had larger BMD losses than men. In the 10,000 IU group, women had a mean BMD loss of 5.5% from baseline vs. 1.9% for men. Women in the 4,000 IU group had a mean loss of 3.8% vs. 1.3% for males. The 400 IU group saw a mean loss of 1.8% for women vs. 0.9% for men.
At the tibia, women in the 10,000 IU group had a mean BMD loss of 3.2%, women in the 4,000 IU group had a mean loss of 2% and the 400 IU group had a 1% loss. By contrast, men in all three groups had almost no change during the 3-year period.
“These results are clinically relevant, as vitamin D supplementation is widely administered to postmenopausal females for osteoporosis prevention,” the researchers said. “These findings raise the possibility that in vitamin D-sufficient females, additional high-dose vitamin D supplementation could actually have a detrimental effect on bone.”
The researchers said the findings are an exploratory outcome from the clinical trial, which was not powered to reveal differences between women and men.
“Different results may be observed in osteoporotic or vitamin D-deficient individuals,” the researchers said. “Further research is needed to determine whether high-dose vitamin D is harmful to bone, particularly for females.”
Reference:
- Burt LA, et al. J Bone Miner Res. 2020;doi:10.1002/jbmr.4152.
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Burt LA, et al. High-dose vitamin D supplementation affects bone density differently in females than males. Presented at: American Society for Bone and Mineral Research Annual Meeting; Sept. 11-15, 2020 (virtual meeting).
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