Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study
Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study
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DOI：
10.1016/j.bone.2006.09.026
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发表时间：
2007-03-01
期刊：
影响因子：
4.1
通讯作者：
Delmas, P. D.
中科院分区：
文献类型：
--
作者：
Garnero, P.;Munoz, F.;Delmas, P. D.
简介：维生素D状态被认为是骨骼健康的重要决定因素，但维生素D-3补充试验产生了相互矛盾的结果。本研究旨在探讨绝经后妇女血清25-羟维生素D（25-OH D）、骨转换指标、骨密度（BMD）、桡骨骨丢失与骨折发生率的关系。研究方法：对669名绝经后妇女（平均年龄：62.2岁）进行前瞻性随访，中位数为11.2年。在基线时，25-OH D水平，BMD，骨转换标志物和骨质疏松症的临床危险因素进行了评估。通过每年测量BMD估计桡骨BMD损失，并通过X线片证实134名妇女发生的所有新发骨折。结果如下：73%和35%的妇女血清25-OH D水平低于75和50 nmol/l，分别对应于最近提出的骨折预防的最佳值的中位数和最低值。11%的女性水平低于30 nmol/l。血清25-OH D与完整的PTH适度相关（r（2）= 0.023，p < 0.0001），但与骨转换标志物或年龄校正后的髋部和桡骨BMD无关。当25-OH D水平被认为是一个连续变量时，25-OH D水平与桡骨BMD丢失或骨折风险之间没有显著相关性。校正年龄后，25-OH D水平低于或高于75、50或30 nmol/l的妇女在骨折、BMD、桡骨BMD丢失、骨转换标志物、握力和前一年跌倒者百分比方面无显著差异。结论：在家庭居住的健康绝经后妇女中，很少有严重的维生素D缺乏症，维生素D状况可能不是骨骼健康的重要决定因素。(c)2006爱思唯尔公司All rights reserved.
Introduction: Vitamin D status is considered as an important determinant of bone health but supplementation trials with vitamin D-3 have yielded conflicting results. The aim of this study was to investigate the associations between serum 25-hydroxyvitamin D (25-OH D), bone turnover markers, bone mineral density (BMD), radius bone loss and incidence of fracture in postmenopausal women. Methods: 669 postmenopausal women (mean age: 62.2 years) belonging to a population-based cohort were followed prospectively for a median of 11.2 years. At baseline, 25-OH D levels, BMD, bone turnover markers and clinical risk factors of osteoporosis were assessed. BMD loss at the radius was estimated by annual measurements of BMD and all incident fractures which occurred in 134 women were confirmed by radiographs. Results: 73% and 35% of women had serum 25-OH D levels below 75 and 50 nmol/l which correspond respectively to the median and lowest optimal values recently proposed for fracture prevention. 11% of women had levels below 30 nmol/l. Serum 25-OH D correlated modestly with intact PTH (r(2) = 0.023, p < 0.0001), but not with bone turnover markers or BMD at the hip and radius after adjustment for age. When levels of 25-OH D were considered as a continuous variable, there was no significant association between 25-OH D levels and radius BMD loss or fracture risk. After adjustment for age, there was no significant difference in incidence of fracture, BMD, radius BMD loss, bone turnover markers, grip strength and the percentage of fallers in the previous year between women with 25-OH D levels below or above 75, 50 or 30 nmol/l. Conclusions: In a population of home-dwelling healthy postmenopausal women with few of them with severe vitamin D deficiency, vitamin D status may not be an important determinant of bone health. (c) 2006 Elsevier Inc. All rights reserved.