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One quarter of all hip fractures occur in men, and 30% of older men experience fragility fractures. However, data are lacking on calcium supplementation for prevention of osteoporosis in men. In a double-blind trial from New Zealand, 323 healthy men (mean age, 57) with normal bone density were randomized to placebo or to calcium supplementation (600 mg daily or 600 mg twice daily). Men with any major active disease or bone-mineral density (BMD) Z scores lower than –2 were excluded.
During 24 months, total body BMD remained stable in the placebo and low-dose calcium groups but rose by 1.5% in the high-dose calcium group. Lumbar and mean total-hip BMD of high-dose patients rose relative to BMDs in placebo and low-dose patients. Additional biochemical testing, conducted in a randomly selected subgroup, showed a dosage-related decrease in parathyroid hormone and bone turnover. No significant differences were noted in rates of fractures or serious adverse events in all three groups.
Reid IR et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med 2008 Nov 10; 168:2276.
Comment
Many argue that sex bias — favoring men — permeates medical research and clinical medicine. Notably, this trial represents an attempt to redress the tendency to study osteoporosis exclusively in women. The results suggest that calcium supplementation is as important for men as it is for women. Additional studies will be required to determine precise dosing regimens (calcium 600 mg daily vs. 600 mg twice daily), the role of vitamin D supplementation in men, and supplementation’s effect on fracture risk.