Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women.
Although only few postmenopausal women exhibit biochemical signs of hypovitaminosis D, vitamin D insufficiency has been shown to have adverse effects on bone metabolism and could be an important risk factor for osteoporosis and fracture. We determined serum levels of 25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), bone turnover markers, dietary calcium intake, and bone mineral density (BMD; measured by dual X-ray absorptiometry) in 161 consecutive ambulatory women, healthy except for osteoporosis, referred to a bone metabolic unit. The prevalence of vitamin D insufficiency [25(OH)D < or = 15 ng/ml] was 39.1%. 25(OH)D was lower in the osteoporotic subjects (15.7 +/- 5.3 ng/ml vs. 21.8 +/- 9.7 ng/ml; p < 0.001). After controlling for all other variables, lumbar spine (LS) BMD was found to be significantly associated with 25(OH)D, body mass index (BMI), and years after menopause (YSM) (R2 = 0.253; p < 0.001). For femoral neck (FN), significant independent predictors of BMD were YSM, BMI, iPTH, and 25(OH)D (R2 = 0.368; p < 0.001). The probability of meeting osteoporosis densitometric criteria was higher in the vitamin D insufficiency group (odds ratio [OR], 4.17, 1.83-9.48) after adjusting by YSM, BMI, iPTH, and dietary calcium intake. Our study shows that vitamin D insufficiency in an otherwise healthy postmenopausal population is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.
Mezquita-Raya
P
P
Endocrinology Division, University Hospital San Cecilio, Granada, Spain.
Muñoz-Torres
M
M
Luna
J D
JD
Luna
V
V
Lopez-Rodriguez
F
F
Torres-Vela
E
E
Escobar-Jiménez
F
F
D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism* / Q000503:physiopathology*; D003404:Creatinine / Q000097:blood; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D017698:Postmenopause / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000503:physiopathology
D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D003404:Creatinine; D000469:Alkaline Phosphatase