Impact of vitamin D supplementation on markers of bone turnover: Systematic review and meta-analysis of randomised controlled trials

Eur J Clin Invest. 2023 Oct;53(10):e14038. doi: 10.1111/eci.14038. Epub 2023 Jun 14.

Abstract

Aim: The effects of vitamin D administration on bone turnover markers (BTMs) in adults are controversial. Thus, we carried out a meta-analysis of available randomised controlled trials (RCTs) to examine the impact of vitamin D supplementation on BTMs.

Methods: To identify relevant RCTs, we searched the PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library and Embase databases for manuscripts published up to July 2022. The present study was conducted in agreement with the PRISMA guidelines. Weighed mean difference (WMD) and 95% confidence intervals (CI) were used to calculate the magnitude of the effect of the intervention.

Results: A total of 42 RCTs were included in the meta-analysis. The age of the participants enrolled in the RCTs ranged from 19.4 to 84 years. The pooled results depicted a decrease in deoxypyridinoline (DPD) concentrations (WMD: -1.58 nmol/mmol, 95% CI: -2.55, -.61, p = .001) following vitamin D supplementation. In addition, subgroup analyses demonstrated that vitamin D administration notably reduced procollagen type I N-terminal propeptide (PINP) levels in individuals aged >50 years and led to a pronounced decrease in alkaline phosphatase (ALP) values when the intervention lasted >12 weeks. No significant effect was observed on other BTMs, for example, collagen type 1 cross-linked C-telopeptide (CTX) and osteocalcin (OC) levels.

Conclusion: Vitamin D administration decreases DPD, PINP and ALP levels, indicating a reduced bone turnover following the intervention. Other BTMs, for example, CTX or OC values, were not affected by vitamin D prescription. Vitamin D supplementation may exert a positive effect on some important BTMs.

Keywords: CTX; PINP; bone turnover markers; meta-analysis; osteocalcin; vitamin D supplementation.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Alkaline Phosphatase
  • Biomarkers
  • Bone Remodeling
  • Collagen Type I* / pharmacology
  • Dietary Supplements
  • Humans
  • Osteocalcin / pharmacology
  • Randomized Controlled Trials as Topic
  • Vitamin D*

Substances

  • Procollagen Type I
  • Vitamin D
  • Collagen Type I
  • Alkaline Phosphatase
  • Biomarkers
  • Osteocalcin