To the Editor The systematic review and meta-analysis of RCTs by Dr Zhao and colleagues1 found that treatment with calcium, vitamin D, or both was not associated with reduced risk of fracture incidence compared with placebo or no treatment in community-dwelling elderly individuals. However, there are several important methodological constraints.
First, there may have been errors in data extraction from the primary included studies. For instance, Figure 3 in the article provided primary RCTs investigating the association between vitamin D and risk of fracture. However, the DEX trial did not provide data on hip fracture, and the VitDISH trial looked at blood pressure, not fractures. Furthermore, the authors recorded 1127 participants in the placebo group of the Vital D trial and 5 fractures for the placebo group of the VitaDial trial; review of the studies shows the true numbers were 1125 participants and 10 fractures, respectively.
Tian S, Zhao D. Calcium and Vitamin D Supplements and Fractures in Community-Dwelling Adults. JAMA. 2018;319(19):2043. doi:10.1001/jama.2018.3909
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