Effects of Calcium Supplements on Bone Health Across the Menopausal Transition

The use of calcium dietary supplements was found to be associated with slower decline in femoral neck and lumbar spine bone mineral density (BMD) across the menopausal transition, especially when used by premenopausal women, but there was no association with bone fracture risk, according to study results published in JBMR Plus.

Previous studies have reported mixed results on the association between calcium supplements and the risk for osteoporosis and fractures, and there are conflicting recommendations regarding the use of these supplements for age-related bone disorders. Furthermore, limited data are available on the effects of calcium supplements in premenopausal women.

The goal of the current study was to explore the association between the use of calcium supplements and bone health during the transition to menopause. The researchers investigated changes in lumbar spine and femoral neck BMD and the risk for bone fracture according to use or nonuse of calcium supplements.

The secondary data analysis was based on the Study of Women’s Health Across the Nation (SWAN), a multicenter, multiethnic community-based longitudinal study that followed women across the menopausal transition.

At baseline, 19% of the study population (283/1490 women) used calcium supplements; this rate increased during the follow-up, ranging from 22% to 39%. Almost a quarter (22%) of patients using calcium supplements had a history of prior bone fracture.

After adjustment for race, age, height, weight, time-varying menopausal status, BMD scanner variables, lifestyle habits (physical activity, smoking habits, alcohol consumption), and time-varying vitamin D supplement use, annualized rate of BMD loss (g/cm²/y) was significantly lower among women who used calcium supplements compared with those who did not, at both the femoral neck (-0.00321 vs -0.00400 g/cm²/y, respectively; P <.001) and lumbar spine (-0.00463 vs -0.00529 g/cm²/y, respectively; P =.021).

When stratified by menopausal status, however, this protective association of calcium supplements on BMD was significant among premenopausal women for both the femoral neck (-0.00324 vs -0.00422 g/cm²/y, respectively; P =.002) and lumbar spine (-0.00380 vs -0.00501 g/cm²/y; P =.001) but not among early perimenopausal women.

During approximately 10 years of follow-up, 116 women experienced a total of 140 fractures. There was no significant difference in the risk for fractures between calcium supplement users and nonusers, and these findings were consistent when stratified by menopausal status.

The researchers acknowledged several limitations of the study, including the observational design, small sample size, analyses limited to the SWAN public-use dataset, and limitations secondary to relying on self-reported data on calcium use and fractures.

Disclosure: Several study authors declared affiliations with pharmaceutical or consumer industries. Please see the original reference for a full list of authors’ disclosures.

Follow @EndoAdvisor

Reference

Bailey RL, Zou P, Wallace TC, et al. Calcium supplement use is associated with less bone mineral density loss, but does not lessen the risk of bone fracture across the menopause transition: data from the Study of Women’s Health Across the Nation. JBMR Plus. 2020;4(1):e10246.