(Sponsored by Medical Utilization Management, L.L.C.)
(Sponsored by Medical Utilization Management, L.L.C.)
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CALCIUM AND VITAMIN D Calcium and vitamin D have been shown to be of benefit in the prevention and treatment of osteoporosis in both men and women. Mechanisms include improved intestinal absorption of calcium and decreased parathyroid hormone levels, resulting in decreased bone resorption. This results in the decrease of fractures secondary to osteoporosis. It is of particular importance in postmenopausal women in whom there is no longer a positive action of estrogen on the gastrointestinal absorption and renal tubular resorption of calcium. Those at highest risk are those who are housebound or with decreased exposure to sunlight, where 25-OH vitamin D declines and serum PTH increases. Calcium absorption is also decreased in smokers. The combination of calcium and vitamin D has also been shown to prevent bone loss at the lumbar spine and forearm in corticosteriod treated patients. Of interest is that continuous low-dose hormone replacement therapy combined with adequate calcium and vitamin D provides a bone-sparing effect that is similar or superior to that provided by other, higher-dose hormone replacement therapy regimens in elderly women. There is also support for the hypothesis that high intake of calcium may be beneficial in the prevention of rectal cancer. References Nordin BE. Calcium and osteoporosis. Nutrition 1997 Jul-Aug;13(7-8):664-86. Dawson-Harris B et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997 Sep 4;337(10):670-6. Lane JM. Osteoporosis. Medical management and treatment. Spine 1997 Dec 15;22(24S):32S-37S. Zheng W et al. A prospective cohort study of intake of calcium, vitamin D, and other micronutrients in relation to incidence of rectal cancer among postmenopausal women. Cancer Epidemiol Biomarkers Prev 1998 Mar;7(3):221-5. Reid IR. The roles of calcium and vitamin D in the prevention of osteoporosis. Endocrinol Metab Clin North Am 1998 Jun;27(2):389-98. Lau EM et al. Nutrition and osteoporosis. Curr Opin Rheumatol 1998Jul;10(4):368-72. Baeksgaard L et al. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporos Int 1998;8(3):255-60. Storm D et al/ Calcium supplementation prevents seasonal bone loss and changes in biochemical markers of bone turnover in elderly New England women: a randomized placebo-controlled trial. J Clin Endocrinol Metab 1998 Nov;83(11):3817-25. Krall EA et al. Smoking increases bone loss and decreases intestinal calcium absorption. J Bone Miner Res 1999 Feb;14(2):215-20. Recker RR et al. The effect of low-dose continuous estrogen and progesterone therapy with calcium and vitamin D on bone in elderly women. A randomized, controlled trial. Ann Inter Med 1999 Jun 1;130(11):897-904. Pietinen P et al. Diet abd the risk of colorectal cancer in a cohort of Finnish men. Cancer Causes Control 1999 Oct;10(5):387-96. Homik J et al. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev 2000;(2)"CD000952. |
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