Impact of oral vitamin D3 supplementation on proximal femur fracture incidence in the elderly population

Abstract

Objective: To evaluate the effect of oral vitamin D3 supplementation on the incidence of proximal femur fracture (PFF) in the elderly population.

Materials and Methods: We searched PubMed and Embase databases for relevant studies from inception to March 2024. Only randomized controlled trials (RCTs) were included. Raw data were extracted into a predefined worksheet, and quality analysis of RCTs was performed using the risk-of-bias tool version 2 (RoB2).

Results: Thirteen RCTs were included in the meta-analysis. Oral vitamin D3 supplementation alone in the elderly did not show a significant association with PFF incidence (OR = 1.04, 95% CI: 0.94-1.15, p-value = 0.46 > 0.05). Combined oral supplementation of vitamin D3 and calcium could reduce the incidence of PFF in the elderly population (OR = 0.80, 95% CI: 0.69-0.94, p-value = 0.005 < 0.05); however, after excluding low-quality RCTs, the protective effect was no longer statistically significant (OR = 0.90, 95% CI: 0.74-1.10, p-value = 0.32 > 0.05).

Conclusion: Limited evidence suggests that combined oral supplementation of vitamin D3 and calcium may reduce the incidence of PFF in the elderly population, as the protective effect was no longer statistically significant after excluding low-quality RCTs.

Keywords: Vitamin D3, cholecalciferol, calcium, proximal femur fracture, elderly population, meta-analysis