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Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis

Published online by Cambridge University Press:  15 January 2024

Nasrin Nasimi
Affiliation:
Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Sanaz Jamshidi
Affiliation:
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Aida Askari
Affiliation:
Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Nazanin Zolfaghari
Affiliation:
Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Erfan Sadeghi
Affiliation:
Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
Mehran Nouri
Affiliation:
Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Nick Bellissimo
Affiliation:
Toronto Metropolitan University, School of Nutrition, Toronto, ON M5B-2K3, USA
Shiva Faghih*
Affiliation:
Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
*
*Corresponding author: Shiva Faghih, email shivafaghih@gmail.com

Abstract

Vitamin D is a vital indicator of musculoskeletal health, as it plays an important role through the regulation of bone and mineral metabolism. This meta-analysis was performed to investigate the effects of vitamin D supplementation/fortification on bone turnover markers in women. All human randomised clinical trials reported changes in bone resorption markers (serum C-terminal telopeptide of type-I collagen (sCTX) and urinary type I collagen cross-linked N-telopeptide (uNTX)) or bone formation factors (osteocalcin (OC), bone alkaline phosphatase (BALP) and procollagen type-1 intact N-terminal propeptide (P1NP)) following vitamin D administration in women (aged ≥ 18 years) were considered. Mean differences (MD) and their respective 95 % CI were calculated based on fixed or random effects models according to the heterogeneity status. Subgroup analyses, meta-regression models, sensitivity analysis, risk of bias, publication bias and the quality of the included studies were also evaluated. We found that vitamin D supplementation had considerable effect on sCTX (MD: −0·038, n 22) and OC (MD: −0·610, n 24) with high heterogeneity and uNTX (MD: −8·188, n 6) without heterogeneity. Our results showed that age, sample size, dose, duration, baseline vitamin D level, study region and quality of studies might be sources of heterogeneity in this meta-analysis. Subgroup analysis also revealed significant reductions in P1NP level in dose less than 600 μg/d and larger study sample size (>100 participants). Moreover, no significant change was found in BALP level. Vitamin D supplementation/fortification significantly reduced bone resorption markers in women. However, results were inconsistent for bone formation markers.

Type
Systematic Review and Meta-Analysis
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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