Menopausal bone loss is partially regulated by dietary intake of vitamin D.
Five years ago we reported results from a cross-sectional study of the effect of nutritional factors on calcium-regulating hormones and bone loss in perimenopausal women. We found an inverse correlation between serum 25-hydroxyvitamin D (25OHD) and immunoreactive parathyroid hormone (PTH), and we postulated that over time, women with lower 25OHD would lose more bone because of increased bone remodeling induced by secondary hyperparathyroidism. We have followed 38 of these women for 5 years. Twenty-two have gone through menopause and we are reporting observations on these 22 subjects. Bone mineral analysis was performed twice a year at the distal and mid-radius using single-photon absorptiometry. The slope of the bone mineral content curve was calculated by least squares. Bone loss increased within 6 months of the rise in serum follicle stimulating hormone (FSH) to greater than 40 mIU/ml. We continued to see a negative correlation between 25OHD and PTH (r = -0.450, P = 0.03). Premenopause, PTH was negatively correlated with the proximal bone mineral content (PBMC) slope (-0.604, P = 0.002). The distal bone mineral content (DBMC) 5-year slope was correlated with dietary vitamin D (r = 0.509, P = 0.02), the higher the intake, the less negative the slope. The 5-year PBMC slope was negatively correlated with serum osteocalcin (OC) levels (r = -0.382, P = 0.08). Before menopause, the change in PBMC was positively correlated with OC (r = 0.450, P = 0.03). Postmenopause, the correlation with DBMC slope was negative (r = -0.506, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Lukert
B
B
Department of Medicine, University of Kansas Medical Center, Kansas City 66103.
Higgins
J
J
Stoskopf
M
M
D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D015502:Absorptiometry, Photon; D000284:Administration, Oral; D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000494:pharmacology; D015519:Bone Density; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000008:administration & dosage / Q000494:pharmacology; D003430:Cross-Sectional Studies; D004967:Estrogens / Q000172:deficiency / Q000502:physiology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005527:Food, Fortified; D006801:Humans; D008875:Middle Aged; D008903:Minerals / Q000032:analysis; D015675:Osteocalcin / Q000097:blood; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000008:administration & dosage / Q000494:pharmacology; D011884:Radius / Q000737:chemistry; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*
D004967:Estrogens; D008903:Minerals; D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2; D010758:Phosphorus; D005640:Follicle Stimulating Hormone; D002112:Calcifediol; D001205:Ascorbic Acid; D002118:Calcium