Effect of four monthly oral vitamin D₃ (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial

Editor:
We read with interest the study by Trivedi et al concerning oral vitamin
D3 supplementation on fractures and mortality in men and women living in
the community (1).
The authors found a 22% lower rate for first fracture at any site and 33%
lower rate for a fracture occurring on the hip, wrist or forearm, or
vertebrae. However the age adjusted relative risks in the vitamin D group
compared with the placebo group were: 0,85 ( 95% CI: 0,47-1,53; p=0,59)
for hip and 0,63 ( 95% CI: 0,35-1,14; p= 0,12) for vertebral fracture, and
we don’t know the relative risk for wrist or forearm. Although they refer
that the differences were consistent when stratified by sex, this
difference was not significant (Table 2). With de Cox regression method,
the authors adjust only for age. If the osteoporotic fractures are more
frequent in women than in men and in this study there are more men than
women, we think that an adjustment for sex of relative risk has to be made
too. The 22% reduction in fractures in this study translates to
approximately 250 people treated for one year to prevent any fracture. It
is important to confirm these results because this would mean a prevention
of fractures in high risked people with a minimal cost (< 2 Euros).
1.Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3
(cholecalciferol) supplementation on fractures and mortality in men and
women living in the community: randomised double blind controlled trial.
BMJ.com 2003; 326:469.

Competing interests:  
None declared