Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis
Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis
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DOI：
10.1007/s00198-016-3892-0
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发表时间：
2017-04-01
影响因子：
4
通讯作者：
Min, Y. -K.
中科院分区：
文献类型：
--
作者：
Lee, D. Y.;Jee, J. H.;Min, Y. -K.
这项研究试图确定在绝经后骨量低的妇女中维持骨健康所需的最低血清25-羟基维生素D[25(OH)D]浓度。对于骨骼健康来说，血清25(OH)D浓度为20 ng/mL而不是30 ng/mL是合适的。对于维持骨骼健康所需的最低血清25-羟基维生素D[25(OH)D]浓度尚无共识。本研究旨在探讨现行金标准液质联用仪(LC-MS/MS)测定的25(OH)D与骨转换生化指标、甲状旁腺素(PTH)和骨密度(BMD)的关系。受试者根据血清25(OH)D浓度分为4组：-lt；10、10-20、20-30和a 30 ng/mL。采用协方差分析比较4组间血清骨特异性碱性磷酸酶(BS-ALP)、1型胶原羧基末端交联肽(CTX)、完整甲状旁腺激素(IPTH)和骨密度的变化。25(OH)D与血清BS-ALP、CTX、iPTH呈负相关。仅股骨颈和股骨总BMD与25(OH)D呈显著正相关，根据股骨颈和股骨总BMD的样条图分别估计截止值为11.9和9.7 ng/mL。对于iPTH，黄土区的血清25(OH)D浓度急剧下降，约为20 ng/mL，然后进入平台期。根据本研究，血清25(OH)D浓度为20 ng/mL，而不是30 ng/mL，对骨骼健康是合适的。
This study sought to determine the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health in postmenopausal women with low bone mass. A serum 25(OH)D concentration of 20 ng/mL rather than 30 ng/mL was appropriate for bone health.There is no consensus on the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health. The aim of this study was to investigate the relationship between 25(OH)D measured via liquid chromatography-mass spectrometry (LC-MS/MS), which is the current gold standard, and biochemical markers of bone turnover, PTH, and bone mineral densitometry (BMD).The medical records of 750 postmenopausal women newly diagnosed with osteoporosis or osteopenia at Samsung Medical Center from 2009 to 2014 were investigated. Subjects were divided into four groups according to serum 25(OH)D concentration: < 10, 10-20, 20-30, and a 30 ng/mL. Serum concentrations of bone-specific alkaline phosphatase (BS-ALP), carboxy-terminal cross-linking telopeptide of type 1 collagen (CTx), intact PTH (iPTH), and BMD were compared among the four groups using analysis of covariance. Thresholds of 25(OH)D were then assessed using spline plots and locally weighted regression smoothing (LOESS) plots.25(OH)D was negatively correlated with serum BS-ALP, CTx, and iPTH. Only femur neck and total femur BMD had significant positive relationships with 25(OH)D. Cutoff values of 11.9 and 9.7 ng/mL were estimated from the spline plots of femur neck and total femur BMD, respectively. For iPTH, the LOESS plot showed a steep decrease to a serum 25(OH)D concentration of about 20 ng/mL, followed by a plateau.According to this study, a serum 25(OH)D concentration of 20 ng/mL, rather than 30 ng/mL, was appropriate for bone health.