Femoral Volumetric Bone Density, Geometry, and Strength in Relation to 25-Hydroxy Vitamin D in Older Men

Martin, Erika; Haney, Elizabeth M; Shannon, J.; Cauley, Jane A.; Ensrud, Kristine E.; Keaveny, Tony M.; Zmuda, Joseph M.; Orwoll, Eric S.; Harrison, Stephanie L.; Marshall, Lynn M.

doi:10.1002/jbmr.2360

Cited by 27 publications

(17 citation statements)

References 41 publications

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“…A recent article showed how in older men, higher levels of endogenous 25(OH)D may increase wholebone strength by increasing femoral volumetric BMD and cortical volume [31]. It would be very interesting to assess effects of vitamin D supplementation and of antiosteoporotic therapy on cortical index rather than BMD over time.…”

Section: Discussionmentioning

confidence: 98%

Femoral cortical index: an indicator of poor bone quality in patient with hip fracture

et al. 2015

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Section: Discussionmentioning

confidence: 98%

Femoral cortical index: an indicator of poor bone quality in patient with hip fracture

et al. 2015

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“…Even in the general population without PHPT, there are limited data using newer imaging modalities (such as cQCT and TBS) on the effect of vitamin D deficiency and insufficiency on skeletal health. In a subset of the MrOS study, 25OHD level was positively associated with integral vBMD and cortical volume at the hip as measured with cQCT in elderly men [37]. Standard clinical thresholds for vitamin D deficiency and insufficiency, however, were not utilized in this study and the effect of 25OHD level was small.…”

Section: Discussionmentioning

confidence: 99%

Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism

Walker

Saeed

et al. 2016

Osteoporos Int

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Summary Lower vitamin D and higher parathyroid hormone (PTH) levels are associated with higher volumetric BMD and bone strength at the lumbar spine as measured by central quantitative computed tomography in primary hyperparathyroidism (PHPT), but there are no differences in bone microarchitecture as measured by trabecular bone score (TBS). Introduction The purpose of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) and volumetric bone mineral density (vBMD) and the TBS at the lumbar spine (LS) in PHPT. Methods This is a cross-sectional analysis of PHPT patients with and without low 25OHD. We measured vBMD with quantitative computed tomography (cQCT) and TBS by dual-energy X-ray absorptiometry (DXA) at the LS in 52 and 88 participants, respectively. Results In the cQCT cohort, those with lower vitamin D (<20 vs. 20–29 vs. ≥30 ng/ml) tended to be younger (p = 0.05), were less likely to use vitamin D supplementation (p < 0.01), and had better renal function (p = 0.03). Those with 25OHD <20 ng/ml had 80 and 126 % higher serum PTH levels respectively vs. those with 25OHD 20–29 ng/ml (p = 0.002) and 25OHD ≥30 ng/ml (p < 0.0001). Covariate-adjusted integral and trabecular vBMD were higher in those with 25OHD 20–29 vs. those with 25OHD ≥30 ng/ml, but those with 25OHD <20 did not differ. Because there were few participants with 25OHD deficiency, we also compared those with vitamin D <30 vs. ≥30 ng/ml. Covariate-adjusted integral and trabecular vBMD were 23 and 30 % higher respectively (both p < 0.05) in those with vitamin D <30 vs. ≥30 ng/ml. TBS was in the partially degraded range but did not differ by vitamin D status. Conclusion In mild PHPT, lower 25OHD is associated with higher PTH, but vitamin D deficiency and insufficiency using current clinical thresholds did not adversely affect lumbar spine skeletal health in PHPT. Further work is needed to determine if higher vBMD in those with lower vitamin D is due to an anabolic effect of PTH.

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“…Only a few other studies have reported an association between serum 25(OH)D and BUA [32, 37], but a significant number of studies have investigated this association with BMD as the outcome [2, 36, 38–45]. The reports on this association do not agree across studies.…”

Section: Discussionmentioning

confidence: 99%

Ethnic Variations in Serum 25(OH)D Levels and Bone Ultrasound Attenuation Measurements in Blacks and Whites

Sakamoto

Thorpe

Knutsen

et al. 2017

J. Racial and Ethnic Health Disparities

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Vitamin D deficiency is more common in Blacks, yet Blacks have lower prevalence of bone fragility fractures or osteoporosis than Whites. Broadband ultrasound attenuation (BUA) has been used to explore the association between serum 25(OH)D levels and bone quality in White and non-white populations. We investigated serum 25(OH)D status with corresponding BUA measurements assessed cross sectionally in a cohort of 232 Blacks and 260 Whites, aged 30–95 years who were part of the calibration study of the large Adventist Health Study-2 (AHS-2). At the calibration clinics, calcaneal BUA was measured and blood drawn for serum 25(OH)D assessment. In multivariable analyses, BUA was negatively associated with age (β-coefficient = −0.38; p < 0.0001) and positively associated with body mass index (BMI) (p-(trend) < 0.0001) and positively, but non-significantly, associated with serum 25(OH)D levels. Also, as expected, females had lower BUA (β-coefficient = −5.19; p < 0.05) and Blacks had higher BUA (β-coefficient = 4.26; p < 0.05). Gender and race modified the relationship of serum 25(OH)D on BUA with a positive association in males (p(trend) ≤ 0.05), but no significant association in females after also controlling for menopausal status and hormone therapy. After also controlling for serum 25(OH)D levels, Black males had higher BUA than White men, but such differences were not found among the females. When stratifying on race, a positive association between serum 25(OH)D levels and BUA (p(trend) ≤ 0.05) was found in Blacks, but not among Whites. Further studies are needed to understand how racial/ethnic differences in serum 25(OH)D levels influence bone health.

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Femoral Volumetric Bone Density, Geometry, and Strength in Relation to 25-Hydroxy Vitamin D in Older Men

Cited by 27 publications

References 41 publications

Femoral cortical index: an indicator of poor bone quality in patient with hip fracture

Femoral cortical index: an indicator of poor bone quality in patient with hip fracture

Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism

Ethnic Variations in Serum 25(OH)D Levels and Bone Ultrasound Attenuation Measurements in Blacks and Whites

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