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Association of Calcium and Vitamin D Supplements with Fractures in Persons with a Traumatic SCI.

Le B, Xu HN, Weaver FM, Huo ZJ, Avidano R, Hurlburt P, Morgan S, Carbone L. Association of Calcium and Vitamin D Supplements with Fractures in Persons with a Traumatic SCI. Topics in spinal cord injury rehabilitation. 2024 Feb 29; 30(1):98-112.

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Abstract:

BACKGROUND: Osteoporotic fractures occur in almost half of patients with a spinal cord injury (SCI) and are associated with significant morbidity and excess mortality. Paralyzed Veterans Administration (PVA) guidelines suggest that adequate calcium and vitamin D intake is important for skeletal health, however, the association of these supplements with osteoporotic fracture risk is unclear. OBJECTIVES: To determine the association of filled prescriptions for calcium and vitamin D with fracture risk in Veterans with an SCI. METHODS: The 5897 persons with a traumatic SCI of at least 2 years' duration (96% male; 4% female) included in the VSSC SCI/D Registry in FY2014 were followed from FY2014 to FY2020 for incident upper and lower extremity fractures. Filled daily prescriptions for calcium or vitamin D supplements for 6 months with an adherence 80% were examined. RESULTS: Filled prescriptions for calcium (hazard ratio [HR] 0.65; 95% CI, 0.54-0.78) and vitamin D (HR 0.33; 95% CI, 0.29-0.38) supplements were associated with a significantly decreased risk for incident fractures. CONCLUSION: Calcium and vitamin D supplements are associated with decreased risk of fracture, supporting PVA guidelines that calcium and vitamin D intake are important for skeletal health in persons with an SCI.




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