Effects of Calcium and Vitamin D Supplementation on Bone Mineral Density and Biochemical Markers in Osteoporotic Postmenopausal Women

  • Kim, Jeong, Seon (Department of Oriental Medical Food & Nutrition, Semyung University) ;
  • Kim, Joo-Hak (Department of Orthopedics, College of Medicine, Kwandong University)
  • Published : 2006.02.01


It has been reported that taking a proper amount of calcium and vitamin D helps to increase bone mineral density (BMD) and is effective in decreasing the risk of osteoporosis. This study investigated the supplementary effects of calcium and vitamin D on postmenopausal women who had osteoporosis and used calcium and vitamin D supplements. The study subjects consisted of osteoporotic postmenopausal women who were recruited from the Department of Orthopedics in a university-affiliated hospital. Sixty-seven study subjects were orally administrated 1,000 mg of calcium (calcium carbonate) and 2.5 mg of active vitamin D (1-$\alpha$ hydroxyvitamin D) (cholecalciferol 250 IU) twice a day for a year and a half. BMD and biochemical markers were evaluated and repeated every six months. One year after the intervention test, the bone mineral density of the lumbar spine was significantly increased as compared to the baseline. Six months after supplement administration, the level of serum alkaline phosphatase began to decrease, and afterwards a significant difference was maintained Concentration of 1, 25-dihydroxy-vitamin D at 1.5 years was higher than that of the baseline. In comparison with that of the baseline, the level of urinary hydroxyproline in the study subjects over six months was significantly decreased This study continued that effects such as BMD improvement and changes in biochemical markers appeared at least one year after administration of supplements.


  1. WHO/FAO Expert Consultation. Diet nutrition and the prevention of chronic disease. WHO Technical Report Series 916. 2003
  2. Wallace LS, Ballard JE. Lifetime physical activity and calcium intake related to bone density in young women. J Womens Health Gend Based Med 11:389-398, 2002 https://doi.org/10.1089/152460902317586029
  3. Malabanan AO, Holick MF. Vitamin D and bone health in postmenopausal women. J Womens Health 12:151-156, 2003 https://doi.org/10.1089/154099903321576547
  4. Campbell BG, Ketchell D, Gunning K. Do calcium supplements prevent postmenopausal osteoporotic fractures? J Farm Pract 52:234-237, 2003
  5. Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L. et al. Meta-analysis of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev 23:552-559, 2002 https://doi.org/10.1210/er.2001-7002
  6. Kaufman JM. Role of calcium and vitamin D in the prevention and the treatment of postmenopausal osteoporosis: an overview. Clin Rheumatol 14:9-13, 1995 https://doi.org/10.1007/BF02210681
  7. Kim J, Kim DH, Ahn YO, Tokudome Y, Hamajima N, Inoue M, Tajima T. Reproducibility of a food frequency questionnaire. Asian Pacific Journal of Cancer Prevention 4:253-257, 2003
  8. Kim J, Ahn YO, Paik HY, Hamajima N, Inoue M, Tajima T. Calibration of a food frequency questionnaire in Koreans. Asia Pacific Journal of Clinical Nutrition 12:243-249, 2003
  9. Korean Nutrition Society. Dietary Reference Intakes for Koreans. 2005
  10. Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women:a randomized controlled trial. Am J Med 98:331-335, 1995 https://doi.org/10.1016/S0002-9343(99)80310-6
  11. Huuskonen J, Vaisanen SB, Kroger H, Jurvelin JS, Alhava E, Rauramaa R. Regular physical exercise and bone mineral density:a four-year controlled randomized trial in middle-aged men. The DNASCO study. Osteoporosis Int 12:349-355, 2001 https://doi.org/10.1007/s001980170101
  12. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr 72:745-750, 2000 https://doi.org/10.1093/ajcn/72.3.745
  13. Recker RR, Hinders S, Davies KM, Heaney RP, Stegman MR, Lappe JM, Kimmel DB. Correcting calcium nutritional deficiency prevents spine fractures in elderly women. J Bone Miner Res 11:1961-1966, 1996 https://doi.org/10.1002/jbmr.5650111218
  14. Riggs BL, O'Fallon WM, Mhus J, O'Connor MK, Kumar R, Melton LJ III. Long-term effects of calcium supplementation on serum parathyroid hormone level, bone density in men and women 65 years of age or older. J Bone Miner Res 13:168-174, 1998 https://doi.org/10.1359/jbmr.1998.13.2.168
  15. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670-676, 1997 https://doi.org/10.1056/NEJM199709043371003
  16. Christiansen C, Christensen MS, McNair P, Hagen C, Stocklund KE, Transbol I. Prevention of early postmenopausal bone loss:Controlled 2-year study in 315 normal females. Eur J Clin Invest 10:273-279, 1980 https://doi.org/10.1111/j.1365-2362.1980.tb00033.x
  17. Larsen ER, Mosekilde L, Foldspang A. Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents:A pragmatic population- based 3-year intervention study. J Bone Miner Res 19:370-378, 2004 https://doi.org/10.1359/JBMR.0301240
  18. Meier C, Woitge HW, Witte K, Lemmer B, Seibel MJ. Supplementation with oral vitamin $D_3$ and calcium during winter prevents seasonal bone loss:a randomized controlled open-label prospective trial. J Bone Mineral Research 19:1221-1230, 2004 https://doi.org/10.1359/JBMR.040511
  19. Karachalios T, Lyritis GP, Kaloudis J, Roidis N, Katsiri M. The effects of calcitonin on acute bone Ioss after pertrochanteric fractures. J Bone Joint Surg 86:350-358, 2004 https://doi.org/10.1302/0301-620X.86B3.14300
  20. Sairanen S, Karkkainen M, Tahtela R, Laitinen K, Makela P, Lamberg- Allardt C, Valimaki MJ. Bone mass and markers of bone and calcium metabolism in postmenopausal women treated with 1, 25-Dihydroxyvitamin D (calcitriol) for four years. Calcif Tissue Int 67:122-127, 2000 https://doi.org/10.1007/s00223001118
  21. Tiylard MW, Spears GFS, Thomson J, Dovey S. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 326:357-362, 1992 https://doi.org/10.1056/NEJM199202063260601
  22. Chen IT, Shiraki M, Hasumi K, Tanaka N, Katase K, Kato T, Horai Y, Nakamura T, Ogata E. I-alfa hydroxyvitamin $D_3$ treatment decreases bone turnover and modulates calcium-regulating hormones in early postmenopausal women. Bone 20;557-562, 1997 https://doi.org/10.1016/S8756-3282(97)00054-9
  23. Heaney RP. Interpreting trials of bone-active agents. Am J Med 98;329-330, 1995 https://doi.org/10.1016/S0002-9343(99)80309-X
  24. Bertoli A, DiDaniele N, Troisi A, Lauro R. A woman with bone pain, fractures, and malabsorption. Lancet 347:300, 1996 https://doi.org/10.1016/S0140-6736(96)90470-5
  25. Peacock M, Liu G, Carey M, McClintock R, Amtrosium W, Hui S. et al. Effect of calcium or 25 (OH) vitamin $D_3$ dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab 85:3011-3019, 2000 https://doi.org/10.1210/jc.85.9.3011
  26. Wu XP, Laio EY, Zhang H, Dai RC, Shan PF, Cao XZ, Lui SP, Jiang Y. Determination of age-specific bone mineral density and comparison of diagnosis and prevalence of primary osteoporosis in Chinese women based on both Chinese and World Health Organization criteria. J Bone Miner Metab 22:382-391, 2004