Effects of intermittent overload doses of oral vitamin D3 on serum 25(OH)D concentrations and the incidence rates of fractures, falls, and mortality in elderly individuals: A systematic review and meta-analysis.

2024-09-06
Biomolecules & biomedicine 24(5)
- Xiaoyang Tao
- Wupeng Yang
- Qinxin Zhang
- Yongjiang Wang
- Feng Gao
- Yuehan Wang
- Tingxin Zhang
- Hao Liu
- Jindong Chen

PubMed: 38615341
DOI: 10.17305/bb.2024.10449

Study Design

Type: Meta-Analysis
Population: elderly individuals
Methods: Meta-analysis of 14 RCTs on high-dose intermittent oral vitamin D3 (over 800 IU per day) monthly administration

Vitamin D is commonly used to prevent and treat osteoporosis, with studies indicating its potential to reduce fractures, falls, and mortality. However, meta-analyses present inconsistent findings regarding its efficacy, particularly reflecting significant variability in data and outcomes related to various dosing regimens. In this meta-analysis, we assessed the impact of high-dose intermittent oral administration of vitamin D3 on serum 25(OH)D levels, fractures, falls, and mortality among elderly individuals. We included 14 randomized controlled trials (RCTs) and employed Review Manager 5.4 for statistical analysis. Our findings indicate that intermittent monthly administration of vitamin D3 (over 800 IU per day) significantly raised serum 25(OH)D levels at all timepoints after six months, maintaining levels above 75 nmol/L throughout the year. This regimen showed no increase in all-cause mortality, with a risk ratio (95% CI) of 0.95 (0.87-1.04). Likewise, it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively. Although one-year intermittent administration significantly increased the concentration of 25(OH)D in serum, further research is needed to determine if this method would increase the incidence of falls. Therefore, it is not recommended at this stage due to the lack of demonstrated safety in additional relevant RCTs. This study had been registered at PROSPERO (CRD42022363229).

Research Insights

Vitamin D→Reduced All-Cause Mortality
This regimen showed no increase in all-cause mortality, with a risk ratio (95% CI) of 0.95 (0.87-1.04).
Effect
Neutral
Effect size
Small
Dose
intermittent monthly administration of vitamin D3 (over 800 IU per day)
Vitamin D→Reduced Fall Incidence
Likewise, it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively.
Effect
Neutral
Effect size
Small
Dose
intermittent monthly administration of vitamin D3 (over 800 IU per day)
Vitamin D→Reduced Fracture Incidence
Likewise, it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively.
Effect
Neutral
Effect size
Small
Dose
intermittent monthly administration of vitamin D3 (over 800 IU per day)

Adverse Events Reported

Vitamin D→all-cause mortality
This regimen showed no increase in all-cause mortality, with a risk ratio (95% CI) of 0.95 (0.87-1.04).
Finding
No significant difference
Severity
Serious adverse event
Magnitude
risk ratio (95% CI) of 0.95 (0.87-1.04)
Significant
No
Vitamin D→falls
it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively.
Finding
No significant difference
Magnitude
risk ratios of 1.02 (0.98-1.05)
Significant
No
Vitamin D→fractures
it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively.
Finding
No significant difference
Severity
Serious adverse event
Magnitude
risk ratios ... 0.95 (0.87-1.04)
Significant
No
Vitamin D→falls
further research is needed to determine if this method would increase the incidence of falls. Therefore, it is not recommended at this stage due to the lack of demonstrated safety in additional relevant RCTs.
Finding
Reported