Calcium and vitamin D are essential for maintaining the bone health. However, the efficacy of calcium and vitamin D in prevention of osteoporosis remains controversial given the conflicting evidence from the controlled clinical trials. Moreover, the cardiovascular safety of calcium supplementation has been questioned. Nevertheless, the results of several metaanalyses of clinical studies suggested that in the elderly, particularly in females, calcium ± vitamin D supplementation prevents bone loss and reduces the risk of osteoporotic fractures. The evidence for an increased risk of cardiovascular outcomes associated with calcium intake was inconclusive. Calcium and vitamin D supplements cannot replace bisphosphonated or other anti-osteoporotic agents in patients with an established osteoporosis. However, adequate supplementation with calcium and vitamin D should be ensured in patients who receive drug treatment for osteoporosis. Calcium and vitamin D combination should be also administered for prevention of steroid-induced osteoporosis in all patients treated with corticosteroids, even at low doses, over more than 3 months.
Osteoporosis, prevention, treatment, calcium, vitamin D.