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Low serum vitamin D is associated with higher cortical porosity in elderly men
Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Geriatr Med, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Ctr Bone & Arthrit Res, Inst Med, Gothenburg, Sweden..
Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Geriatr Med, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Ctr Bone & Arthrit Res, Inst Med, Gothenburg, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrinology and mineral metabolism.
Lund Univ, Dept Clin Sci, Clin & Mol Osteoporosis Res Unit, Lund, Sweden.;Skane Univ Hosp, Dept Orthopaed, Malmo, Sweden..
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2016 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 280, no 5, 496-508 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundBone loss at peripheral sites in the elderly is mainly cortical and involves increased cortical porosity. However, an association between bone loss at these sites and 25-hydroxyvitamin D has not been reported. ObjectiveTo investigate the association between serum levels of 25-hydroxyvitamin D, bone microstructure and areal bone mineral density (BMD) in elderly men. MethodsA population-based cohort of 444 elderly men (mean SD age 80.2 3.5 years) was investigated. Bone microstructure was measured by high-resolution peripheral quantitative computed tomography, areal BMD by dual-energy X-ray absorptiometry and serum 25-hydroxyvitamin D and parathyroid hormone levels by immunoassay. ResultsMean cortical porosity at the distal tibia was 14.7% higher (12.5 +/- 4.3% vs. 10.9 +/- 4.1%, P < 0.05) whilst cortical volumetric BMD, area, trabecular bone volume fraction and femoral neck areal BMD were lower in men in the lowest quartile of vitamin D levels compared to the highest. In men with vitamin D deficiency (<25 nmol L-1) or insufficiency [25-49 nmol L-1, in combination with an elevated serum level of parathyroid hormone (>6.8 pmol L-1)], cortical porosity was 17.2% higher than in vitamin D-sufficient men (P < 0.01). A linear regression model including age, weight, height, daily calcium intake, physical activity, smoking vitamin D supplementation and parathyroid hormone showed that 25-hydroxyvitamin D independently predicted cortical porosity (standardized = -0.110, R-2 = 1.1%, P = 0.024), area ( = 0.123, R-2 = 1.4%, P = 0.007) and cortical volumetric BMD ( = 0.125, R-2 = 1.4%, P = 0.007) of the tibia as well as areal BMD of the femoral neck ( = 0.102, R-2 = 0.9%, P = 0.04). ConclusionSerum vitamin D is associated with cortical porosity, area and density, indicating that bone fragility as a result of low vitamin D could be due to changes in cortical bone microstructure and geometry.

Place, publisher, year, edition, pages
2016. Vol. 280, no 5, 496-508 p.
Keyword [en]
cortical porosity, high-resolution peripheral computed tomography, vitamin D
National Category
Orthopedics Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-308907DOI: 10.1111/joim.12514ISI: 000386917400008PubMedID: 27196563OAI: oai:DiVA.org:uu-308907DiVA: diva2:1051221
Funder
Swedish Research Council
Available from: 2016-12-01 Created: 2016-12-01 Last updated: 2016-12-01Bibliographically approved

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