Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 420

In a recent Cochrane Review, fracture outcomes were reported from 53 RCTs or quasi‐randomized trials of supplementation of vitamin D and/or calcium in postmenopausal women or men over age 65 from community, hospital, and nursing‐home settings and 22 trials of primarily participants with established osteoporosis in settings of institutional referral clinics or hospitals.¹⁷ Several forms of vitamin D were examined, including vitamins D2 and D3 (typically in foods and over‐the‐counter supplements) and activated forms of vitamin D (that are activated in the liver and/or kidney: calcidiol, alfacalcidol, and calcitriol). Vitamin D alone was not associated with preventing fractures, while vitamin D with additional calcium supplements reduced the risk of hip fractures and other fractures. Mortality risk was not increased from vitamin D and calcium supplements. However, an increased risk of other adverse effects was noted, such that it was recommended that those with kidney stones, kidney disease, high blood calcium, or gastrointestinal disease or those at risk of heart disease should seek medical advice before taking these supplements.¹⁸