Journal
BONE
Volume 107, Issue -, Pages 124-130Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bone.2017.11.011
Keywords
Vitamin D; Fracture; PTH; Bone density; CKD-MBD; Osteodystrophy
Categories
Funding
- National Research Service Award (NRSA) through the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) [T32DK104717, K24DK110427]
- American Heart Association [0575021N, 14EIA18560026]
- NIH (National Heart, Lung, and Blood Institute [NHLBI], National Institute of Neurological Disorders and Stroke [NINDS]) [HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, U01HL080295, U01HL130114]
- National Institute on Aging [R01AG023629]
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25-hydroxyvitamin D [25(OH)D] may not optimally indicate vitamin D receptor activity. Higher concentrations of its catabolic product 24,25-dihydroxyvitmin D [24,25(OH)(2)D] and a higher ratio of 24,25(OH)(2)D to 25(OH)D (the vitamin D metabolite ratio [VMR]) may provide additional information on receptor activity. We compared the strength of associations of these markers with serum PTH concentrations, hip bone mineral density (BMD), and risk of incident hip fracture in community-living older participants in the Cardiovascular Health Study. Among 890 participants, the mean age was 78 years, 60% were women, and the mean 25(OH)D was 28 11 ng/ml. In cross-sectional analysis, the strength of association of each vitamin D measure with PTH was similar; a 1% higher 25(OH)D, 24,25(OH)(2)D, and VMR were associated with 032%, 0.25%, and 0.26% lower PTH, respectively (p < 0.05 for all). Among 358 participants with available BMD data, we found no associations of 25(OH)D or VMR with BMD, whereas higher 24,25(OH)(2)D was modestly associated with greater hip BMD (1% higher 24,25(OH)2D associated with 0.04% [95% CI 0.01-0.08%] higher BMD). Risk of incident hip fracture risk was evaluated using a case-cohort design. There were 289 hip fractures during a mean follow up time of 8.4 years. Both higher 24,25(OH)(2)D and VMR were associated with lower risk of hip fracture (HR per SD higher, 0.73 [0.61, 0.87] and 0.74 [0.61, 0.88], respectively) whereas 25(OH)D was not associated with hip fracture (HR 0.93 [0.79,1.10]). We conclude that evaluating vitamin D status by incorporating assessment of 24,25(OH)D and the VMR provides information on bone health above and beyond 25(OH)D alone. (C) 2017 Elsevier Inc. All rights reserved.
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