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INTRODUCTION

Recently, osteoporosis disease has become a big burden in the whole world as it impacts social and economic factors negatively. Two impairments in humans that can result in osteoporosis diseases are; loss of bone mineral density and reduction of muscle function. Osteoporosis disease leads to fragile fractures. Then, fragile fractures result in a disability, high morbidity, and mortality rates (Chiodini & Bolland, 2018).  This disease is known for inducing low bone mass that occurs because of an imbalance between bone resorption (breakdown of bones) and bone deposition (new bone formation), which favors bone resorption thereby resulting in alteration in bone remodeling (Cesareo et al., 2015).  To treat Osteoporosis, prevention of fragility fractures is the objective. It has been reported in both observational studies and randomized controlled studies that vitamin D supplementation is likely to delay bone loss among postmenopausal and elderly women. But the role of vitamin D supplementation among healthy postmenopausal women is not yet certain (Cesareo et al., 2015).  Research has shown that almost 1 in every 2 women, and 1 in every 5 men at age 50 or more will experience an osteoporotic fracture in their remaining lifetime (Yao et al., 2019). On the other hand, hip fracture is the most serious type of osteoporotic fracture, with an approximate 30% risk of death in the year after the incident of the hip fracture (Yao et al., 2019). However, the incidence of hip fracture increases with age, especially among women 60 years or above and men who are 70 years or above. This is a clear indicator that hip fracture increases with age. (Yao et al., 2019).

Vitamin D is an organic molecule derived from cholesterol and it has been known to play an effective role in strengthening bones and improving bone health. It is mainly produced by the human skin when exposed to sunlight (Reid & Bolland, 2020). When produced, it is biologically inactive until it undergoes hydroxylation and becomes activated. According to Kim et al., vitamin D has a direct effect on bone cells. Lower levels of Vitamin D are associated with osteoporosis and fractures, whereas the increased level of vitamin has been shown to improve bone health. Clinically, vitamin D deficiency has been associated with bone mineralization defects such as rickets and os­teomalacia. Therefore, good skeletal health is associated with having an adequate level of Vitamin D ((Kim et al., 2015).

In addition, the activated vitamin D performs other important functions which include stimulating intestinal absorption of phosphate and regulation of Calcium levels in the blood (Reid & Bolland, 2020). It does this by preventing both hypercalcemia and hyperphosphatemia since either could result in soft tissue calcification with consequent damage to the tissues. Maintaining calcium levels is very vital for bone health. The dosage response of Vitamin D is dependent on the baseline level of 25-hydroxyvitamin D (Reid & Bolland, 2020). To illustrate, individuals with 25-hydroxyvitamin D levels >30 nmol/L, only require a small dosage of Vitamin D supplementation, whereas those with 25-hydroxyvitamin D <30 nmol/L, supplementation results in substantial increases in 25-hydroxyvitamin D, correction of secondary hyperparathyroidism, normalization of serum calcium and phosphate, and reduction in bone turnover (Reid & Bolland, 2020). Increased intake of vitamin D can lead to health challenges hence need for moderate use is advised. For example, increased supplementation of Vitamin D has been associated with toxicity, induced through hypercalcemia (Kim et al., 2015). Also, Vitamin D excess intake has been attributed to hypercalciuria and renal stones (Kim et al., 2015). It is important to understand this fact that several studies have shown the efficacy of vitamin D supplements with the dose of 400–1000 IU/day, is very safe without side effects (Reid & Bolland, 2020). Clinical trials have shown that vitamin D supplementation between 4000 IU/day and 60,000 IU/month is associated with an increased risk of falls and fractures (Reid & Bolland, 2020).

The role of vitamin D supplementation in the treatment of osteoporosis is still controversial. Some meta-analyses studies have shown that vitamin D supplements on bone density show no clinically significant benefit  (Reid & Bolland, 2020; Burt et al., 2019). Others have shown that individuals with baseline late-winter 25-hydroxyvitamin D levels <30 nmol/L have an ongoing bone loss at a rate of 1%/year when treated with placebo and that this loss is prevented by vitamin D supplementation (Reid & Bolland, 2020; Kim et al., 2015; Burt et al., 2019). In postmenopausal studies, vitamin D supplementation has been found to play a vital role in the treatment of osteoporosis (Cesareo et al.,2015). However, Cesareo et al. concluded that only vitamin D or Calcium supplementation is not enough to treat osteoporosis disease, however, when combined with other osteoporosis drugs its efficacy in treating osteoporosis becomes very clear Cesareo et al.,2015).

AIM

• To determine the effect of vitamin D supplementation on osteoporosis

SPECIFIC OBJECTIVES

• To determine the effect of vitamin D on Bone Mineral Density
• To determine the role of vitamin D on the balance of bone resorption and deposition
• To determine the effect of vitamin D on fragile fractures
• To determine the effect of vitamin D on morbidity rate associated with osteoporosis disease
• To determine the effect of vitamin D on morbidity rate associated with osteoporosis disease

RESEARCH PROBLEM

Osteoporosis disease has become a big burden in the whole world as it impacts social and economic factors negatively. Research has shown that almost 1 in every 2 women, and 1 in every 5 men at age 50 or more will experience an osteoporotic fracture in their remaining lifetime (Yao et al., 2019). Vitamin D is an organic molecule derived from cholesterol and it has been known to play an effective role in strengthening bones and improving bone health. Therefore, it is important to investigate the efficacy of vitamin D on osteoporosis disease.

RESEARCH QUESTION

• What is the effect of vitamin D on Bone Mineral Density?
• What role does vitamin D play in the balance of bone resorption and deposition?
• What is the effect of vitamin D on fragile fractures?
• What is the effect of vitamin D on the morbidity rate associated with osteoporosis disease?
• What is the effect of vitamin D on the morbidity rate associated with osteoporosis disease?

SIGNIFICANCE OF THE STUDY

The role of vitamin D supplementation in the treatment of osteoporosis is still controversial. Some meta-analyses studies have shown that vitamin D supplements on bone density show no clinically significant benefit  (Reid & Bolland, 2020; Burt et al., 2019). Others have shown that vitamin D plays an important role. Therefore, this present study will determine the effect of vitamin D on osteoporosis to assist in proffering solutions to the controversy.

METHODOLOGY

• Study Design: This study will review current literature to determine the effect of stress on cardiovascular diseases. In the search for this literature, keywords such as “Osteoporosis”, “Vitamin D”, “Vitamin D supplementation”, “ Bone health”, “Bone Mineral Density”, and other related terms will be utilized. Databases such as Pubmed/ Medline, Google Scholar, Cochrane library, will also be used to source data Also, Inclusion and exclusion criteria will be used in selecting relevant literature for this study.

ANALYSIS

The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).

RISK ASSESSMENT

The risk assessment conducted for this project is provided in the table below:

Table 1:  Risk assessment

SCHEDULE

    Table 2: Project Plan

References

Burt, L. A., Billington, E. O., Rose, M. S., Raymond, D. A., Hanley, D. A., & Boyd, S. K. (2019). Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: A randomized clinical trial. JAMA - Journal of the American Medical Association, 322(8), 736–745. https://doi.org/10.1001/jama.2019.11889

Cesareo, R., Iozzino, M., D’Onoforio and Terrinoni, I. Meddaloni, E. and Casini, A. (2015). Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis Clinical and genetic bases of metabolic bone diseases, including diabetic osteopathy. Minerva Endocrinol. 40: 231-237.

Chiodini, I., & Bolland, M. J. (2018). Calcium supplementation in osteoporosis: Useful or harmful? In European Journal of Endocrinology (Vol. 178, Issue 4, pp. D13–D25). BioScientifica Ltd. https://doi.org/10.1530/EJE-18-0113

Kim, K. M., Choi, H. S., Choi, M.-J., & Chung, H. Y. (2015). Calcium and Vitamin D Supplementations: 2015 Position Statement of the Korean Society for Bone and Mineral Research. Journal of Bone Metabolism, 22(4), 143. https://doi.org/10.11005/jbm.2015.22.4.143

Reid, I. R., & Bolland, M. J. (2020). Calcium and/or vitamin D supplementation for the prevention of fragility fractures: Who needs it? In Nutrients (Vol. 12, Issue 4). MDPI AG. https://doi.org/10.3390/nu12041011

Yao, P., Bennett, D., Mafham, M., Lin, X., Chen, Z., Armitage, J., & Clarke, R. (2019). Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. In JAMA network open (Vol. 2, Issue 12, p. e1917789). NLM (Medline). https://doi.org/10.1001/jamanetworkopen.2019.17789

Last updated: Jan 21, 2022 04:41 PM