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Published in: Osteoporosis International 1/2016

01-01-2016 | Original Article

Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults

Authors: J. M. Olmos, J. L. Hernández, P. García-Velasco, J. Martínez, J. Llorca, J. González-Macías

Published in: Osteoporosis International | Issue 1/2016

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Abstract

Summary

Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion.

Introduction

This study aims to assess 25-hydroxyvitamin D—25(OH)D—status in Spanish adult subjects and to analyze its relationships with serum PTH levels, calcium intake, and bone mineral density (BMD).

Methods

A total of 1811 individuals (1154 postmenopausal women and 657 men) aged 44–93 years participated in the study. Serum 25(OH)D, intact parathyroid hormone (PTH), aminoterminal propeptide of type I collagen (P1NP), and C-terminal telopeptide of type I collagen (β-CTX) levels were measured by electrochemiluminescence. BMD was determined by dual x-ray absorptiometry (DXA) at lumbar spine, femoral neck, and total hip.

Results

Serum 25(OH)D levels were below 10, 20, and 30 ng/ml in 5, 40, and 83 % of participants, respectively. There was a significant seasonal difference in mean serum 25(OH)D, with higher levels in summer–autumn. In multivariate analysis, 25(OH)D levels were negatively correlated with age, serum PTH and creatinine, body mass index, smoking, alcohol intake, and a number of chronic diseases, but positively with dairy calcium intake. The magnitude of the difference in serum PTH according to 25(OH)D quartiles was not influenced by calcium intake. A threshold of serum 25(OH)D around 30 ng/ml was observed for serum PTH and hip BMD.

Conclusions

Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion. Programs to improve vitamin D status may be required in our country.
Literature
2.
go back to reference McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93:69–77PubMedCrossRef McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93:69–77PubMedCrossRef
3.
go back to reference Van der Wielen RP, Lowik MR, van der Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210PubMedCrossRef Van der Wielen RP, Lowik MR, van der Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210PubMedCrossRef
4.
go back to reference Kuchuk NO, van Schoor NM, Pluijm SM, Chines A, Lips P (2009) Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701PubMedCrossRef Kuchuk NO, van Schoor NM, Pluijm SM, Chines A, Lips P (2009) Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701PubMedCrossRef
5.
go back to reference Bruyère O, Slomian J, Beaudart C, Buckinx F, Cavalier E, Gillain S, Petermans J, Reginster JY (2014) Prevalence of vitamin D inadequacy in European women aged over 80 years. Arch Gerontol Geriatr 59:78–82PubMedCrossRef Bruyère O, Slomian J, Beaudart C, Buckinx F, Cavalier E, Gillain S, Petermans J, Reginster JY (2014) Prevalence of vitamin D inadequacy in European women aged over 80 years. Arch Gerontol Geriatr 59:78–82PubMedCrossRef
7.
go back to reference Lips P (2001) Vitamin D, deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:447–501 Lips P (2001) Vitamin D, deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:447–501
8.
go back to reference Bates CJ, Carter GD, Mishra GD, O’Shea D, Jones J, Prentice A (2003) In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? Osteoporos Int 14:152–159PubMed Bates CJ, Carter GD, Mishra GD, O’Shea D, Jones J, Prentice A (2003) In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? Osteoporos Int 14:152–159PubMed
10.
go back to reference Heaney RP (2005) Vitamin D, requirement in health and disease. Steroid Biochem Mol Biol 97:13–19CrossRef Heaney RP (2005) Vitamin D, requirement in health and disease. Steroid Biochem Mol Biol 97:13–19CrossRef
11.
go back to reference Steingrimsdottir L, Gunnarson O, Indidason OS, Franzson L, Sigurdson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341PubMedCrossRef Steingrimsdottir L, Gunnarson O, Indidason OS, Franzson L, Sigurdson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341PubMedCrossRef
12.
go back to reference Adami S, Viapiana O, Gatti D, Idolazzi L, Rossini M (2008) Relationship between serum parathyroid hormone, vitamin D sufficiency, age, and calcium intake. Bone 42:267–270PubMedCrossRef Adami S, Viapiana O, Gatti D, Idolazzi L, Rossini M (2008) Relationship between serum parathyroid hormone, vitamin D sufficiency, age, and calcium intake. Bone 42:267–270PubMedCrossRef
13.
go back to reference Kuchuck NO, Pluijm SM, van Schoor NM, Looman CWN, Smit JH, Lips P (2009) Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab 94:1244–1250CrossRef Kuchuck NO, Pluijm SM, van Schoor NM, Looman CWN, Smit JH, Lips P (2009) Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab 94:1244–1250CrossRef
14.
go back to reference Hernández JL, Olmos JM, Pariente E, Martínez J, Valero C, García-Velasco P, Nan D, Llorca J, González-Macías J (2010) Metabolic syndrome and bone metabolism. Menopause 17:955–961PubMedCrossRef Hernández JL, Olmos JM, Pariente E, Martínez J, Valero C, García-Velasco P, Nan D, Llorca J, González-Macías J (2010) Metabolic syndrome and bone metabolism. Menopause 17:955–961PubMedCrossRef
15.
go back to reference Olmos JM, Hernández JL, Martínez J, Pariente E, Llorca J, González-Macías J (2010) Bone turnover markers in Spanish adult men. The Camargo Cohort Study. Clin Chim Acta 411:1511–1515PubMedCrossRef Olmos JM, Hernández JL, Martínez J, Pariente E, Llorca J, González-Macías J (2010) Bone turnover markers in Spanish adult men. The Camargo Cohort Study. Clin Chim Acta 411:1511–1515PubMedCrossRef
16.
go back to reference Díez A, González-Macías J, Marín F, Abizanda M, Alvarez R, Gimeno A, for the ECOSAP study investigators et al (2007) Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound. Osteoporos Int 18:629–639CrossRef Díez A, González-Macías J, Marín F, Abizanda M, Alvarez R, Gimeno A, for the ECOSAP study investigators et al (2007) Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound. Osteoporos Int 18:629–639CrossRef
17.
go back to reference Berry EM, Gupta MM, Turner SJ, Burns RR (1973) Variations in plasma calcium with induced changes in plasma specific gravity, total protein, and albumin. Br Med J 4:640–643PubMedPubMedCentralCrossRef Berry EM, Gupta MM, Turner SJ, Burns RR (1973) Variations in plasma calcium with induced changes in plasma specific gravity, total protein, and albumin. Br Med J 4:640–643PubMedPubMedCentralCrossRef
18.
go back to reference Looker AC, Orwoll ES, Johnston CC et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768PubMedCrossRef Looker AC, Orwoll ES, Johnston CC et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768PubMedCrossRef
19.
go back to reference Riancho JA, Valero C, Hernández JL, Olmos JM, Paule B, Zarrabeitia A, González-Macías J (2007) Biomechanical indices of the femoral neck estimated from the standard DXA output: age- and sex-related differences. J Clin Densitomet 10:39–45CrossRef Riancho JA, Valero C, Hernández JL, Olmos JM, Paule B, Zarrabeitia A, González-Macías J (2007) Biomechanical indices of the femoral neck estimated from the standard DXA output: age- and sex-related differences. J Clin Densitomet 10:39–45CrossRef
20.
go back to reference Ruston D, Hoare J, Henderson L, Bates CJ, Prentice A, Birch M (2004) National Diet and Nutrition Survey: adults aged 19–64 years. In Volume 4: nutritional status (anthropometry and blood analytes), blood pressure and physical activity. TSO. London Ruston D, Hoare J, Henderson L, Bates CJ, Prentice A, Birch M (2004) National Diet and Nutrition Survey: adults aged 19–64 years. In Volume 4: nutritional status (anthropometry and blood analytes), blood pressure and physical activity. TSO. London
21.
go back to reference Rockell JEP, Skeaff CM, Williams SM, Green TJ (2006) Serum 25-hydroxyvitamin D concentrations of New Zealanders aged 15 years and older. Osteoporos Int 17:1382–1389PubMedCrossRef Rockell JEP, Skeaff CM, Williams SM, Green TJ (2006) Serum 25-hydroxyvitamin D concentrations of New Zealanders aged 15 years and older. Osteoporos Int 17:1382–1389PubMedCrossRef
22.
go back to reference Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahynoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–777PubMedCrossRef Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahynoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–777PubMedCrossRef
23.
go back to reference Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE et al (2010) IOF position statement vitamin D recommendations for older adults. Osteoporos Int 21:1151–1154PubMedCrossRef Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE et al (2010) IOF position statement vitamin D recommendations for older adults. Osteoporos Int 21:1151–1154PubMedCrossRef
24.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CW (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930PubMedCrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CW (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930PubMedCrossRef
25.
go back to reference Gómez Alonso C, Naves ML, Fernández JL, Díaz-López JB, Fernández MT, Cannata J (2003) Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels. Kidney Int 85:S44–S48CrossRef Gómez Alonso C, Naves ML, Fernández JL, Díaz-López JB, Fernández MT, Cannata J (2003) Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels. Kidney Int 85:S44–S48CrossRef
26.
go back to reference González-Molero I, Morcillo S, Valdés S, Pérez-Valero V, Botas P, Delgado E, Hernández D, Olveira G, Rojo G, Gutiérrez-Repiso C, Rubio-Martín E, Menéndez E, Soriguer F (2011) Vitamin D deficiency in Spain: a population-based cohort study. Eur J Clin Nutr 65:321–328PubMedCrossRef González-Molero I, Morcillo S, Valdés S, Pérez-Valero V, Botas P, Delgado E, Hernández D, Olveira G, Rojo G, Gutiérrez-Repiso C, Rubio-Martín E, Menéndez E, Soriguer F (2011) Vitamin D deficiency in Spain: a population-based cohort study. Eur J Clin Nutr 65:321–328PubMedCrossRef
27.
go back to reference Quesada JM, Jans I, Benito P, Jimenez JA, Bouillon R (1989) Vitamin D status of elderly people in Spain. Age Ageing 18:392–397PubMedCrossRef Quesada JM, Jans I, Benito P, Jimenez JA, Bouillon R (1989) Vitamin D status of elderly people in Spain. Age Ageing 18:392–397PubMedCrossRef
28.
go back to reference Pérez-Llamas F, López-Contreras MJ, Blanco MJ, López-Azorín F, Zamora S, Moreiras O (2008) Seemingly paradoxical seasonal influences on vitamin D status in nursing-home elderly people from Mediterranean area. Nutrition 24:414–420PubMedCrossRef Pérez-Llamas F, López-Contreras MJ, Blanco MJ, López-Azorín F, Zamora S, Moreiras O (2008) Seemingly paradoxical seasonal influences on vitamin D status in nursing-home elderly people from Mediterranean area. Nutrition 24:414–420PubMedCrossRef
29.
go back to reference Calatayud M, Jódar E, Sánchez R, Guadalix S, Hawkins F (2009) Prevalence of deficient and insufficient vitamin D levels in a young healthy population. Endocrinol Nutr 56:164–169PubMedCrossRef Calatayud M, Jódar E, Sánchez R, Guadalix S, Hawkins F (2009) Prevalence of deficient and insufficient vitamin D levels in a young healthy population. Endocrinol Nutr 56:164–169PubMedCrossRef
30.
go back to reference Gómez-de-Tejada MJ, Navarro MD, Saavedra P, Quesada JM, Jódar E, Sosa M (2014) Prevalence of osteoporosis, vertebral fractures and hypovitaminosis D in postmenopausal women living in a rural environment. Maturitas 77:282–286CrossRef Gómez-de-Tejada MJ, Navarro MD, Saavedra P, Quesada JM, Jódar E, Sosa M (2014) Prevalence of osteoporosis, vertebral fractures and hypovitaminosis D in postmenopausal women living in a rural environment. Maturitas 77:282–286CrossRef
31.
go back to reference Quesada-Gómez JM, Diaz-Curiel M, Sosa-Henriquez M, Malouf-Sierra J, Nogues-Solan X, Gomez-Alonso C, Rodriguez-Mañas L, Neyro-Bilbao JL, Cortes X, Delgadillo J (2013) Low calcium intake and inadequate vitamin D status in postmenopausal osteoporotic women. J Steroid Biochem Mol Biol 136:175–177PubMedCrossRef Quesada-Gómez JM, Diaz-Curiel M, Sosa-Henriquez M, Malouf-Sierra J, Nogues-Solan X, Gomez-Alonso C, Rodriguez-Mañas L, Neyro-Bilbao JL, Cortes X, Delgadillo J (2013) Low calcium intake and inadequate vitamin D status in postmenopausal osteoporotic women. J Steroid Biochem Mol Biol 136:175–177PubMedCrossRef
32.
go back to reference Docio S, Riancho JA, Pérez A, Olmos JM, Amado JA, González-Macías J (1998) Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies. J Bone Miner Res 13:544–548PubMedCrossRef Docio S, Riancho JA, Pérez A, Olmos JM, Amado JA, González-Macías J (1998) Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies. J Bone Miner Res 13:544–548PubMedCrossRef
33.
go back to reference Úbeda N, Basagoiti M, Alonso-Aperte E, Varela-Moreiras G (2007) Hábitos alimentarios, estado nutricional y estilos de vida en una población de mujeres menopáusicas españolas. Nutr Hosp 22:313–321PubMed Úbeda N, Basagoiti M, Alonso-Aperte E, Varela-Moreiras G (2007) Hábitos alimentarios, estado nutricional y estilos de vida en una población de mujeres menopáusicas españolas. Nutr Hosp 22:313–321PubMed
34.
go back to reference Bernal M, Cortés G, Giner A, Orden I, Horno M, Benedicto I (2010) Ha mejorado la dotación de vitamina D3 en España? Actuales niveles en una muestra de población. Rev Esp Geriatr Gerontol 45:15–18CrossRef Bernal M, Cortés G, Giner A, Orden I, Horno M, Benedicto I (2010) Ha mejorado la dotación de vitamina D3 en España? Actuales niveles en una muestra de población. Rev Esp Geriatr Gerontol 45:15–18CrossRef
35.
go back to reference Mc Donald HM, Mavroeidi A, Barr RJ, Black AJ, Fraser WD, Reid DM (2008) Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D. Bone 42:996–1003CrossRef Mc Donald HM, Mavroeidi A, Barr RJ, Black AJ, Fraser WD, Reid DM (2008) Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D. Bone 42:996–1003CrossRef
36.
go back to reference Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67:373–378PubMedCrossRef Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67:373–378PubMedCrossRef
37.
go back to reference McLaughin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76:1536–1538CrossRef McLaughin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76:1536–1538CrossRef
39.
go back to reference Tovar-Sánchez A, Sánchez-Quiles D, Basterretxea G, Benedé JL, Chisvert A, Salvador A, Moreno-Garrido I, Blasco J (2013) Sunscreen products as emerging pollutants to coastal waters. PLoS One 8, e65451PubMedPubMedCentralCrossRef Tovar-Sánchez A, Sánchez-Quiles D, Basterretxea G, Benedé JL, Chisvert A, Salvador A, Moreno-Garrido I, Blasco J (2013) Sunscreen products as emerging pollutants to coastal waters. PLoS One 8, e65451PubMedPubMedCentralCrossRef
40.
go back to reference Patel S, Hyer S, Barron J (2007) Glomerular filtration rate is a major determinant of the relationship between 25-hydroxyvitamin D and parathyroid hormone. Calcif Tissue Int 80:221–226PubMedCrossRef Patel S, Hyer S, Barron J (2007) Glomerular filtration rate is a major determinant of the relationship between 25-hydroxyvitamin D and parathyroid hormone. Calcif Tissue Int 80:221–226PubMedCrossRef
41.
go back to reference Pasco JA, Henry MJ, Nicholson GC, Brennan SL, Kotowicz MA (2009) Behavioural and physical characteristics associated with vitamin D status in women. Bone 44:1085–1091PubMedCrossRef Pasco JA, Henry MJ, Nicholson GC, Brennan SL, Kotowicz MA (2009) Behavioural and physical characteristics associated with vitamin D status in women. Bone 44:1085–1091PubMedCrossRef
42.
go back to reference Nimitphong H, Sritara C, Chailurkit LO, Chanprasertyothin S, Ratanachaiwong W, Sritara P, Ongphiphadhanakul B (2015) Relationship of vitamin D status and bone mass according to vitamin D-binding protein genotypes. Nutr J 14:29PubMedPubMedCentralCrossRef Nimitphong H, Sritara C, Chailurkit LO, Chanprasertyothin S, Ratanachaiwong W, Sritara P, Ongphiphadhanakul B (2015) Relationship of vitamin D status and bone mass according to vitamin D-binding protein genotypes. Nutr J 14:29PubMedPubMedCentralCrossRef
43.
go back to reference Institute of Medicine (IOM) (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington, DC Institute of Medicine (IOM) (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington, DC
44.
go back to reference Aloia JF, Talwar SA, Pollack S, Feuerman M, Yeh JK (2006) Optimal vitamin D status and serum parathyroid hormone concentrations in African American women. Am J Clin Nutr 84:602–609PubMedPubMedCentral Aloia JF, Talwar SA, Pollack S, Feuerman M, Yeh JK (2006) Optimal vitamin D status and serum parathyroid hormone concentrations in African American women. Am J Clin Nutr 84:602–609PubMedPubMedCentral
45.
go back to reference Vieth R, Ladak Y, Walfish PG (2003) Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Clin Endocrinol Metab 88:185–191PubMedCrossRef Vieth R, Ladak Y, Walfish PG (2003) Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Clin Endocrinol Metab 88:185–191PubMedCrossRef
Metadata
Title
Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults
Authors
J. M. Olmos
J. L. Hernández
P. García-Velasco
J. Martínez
J. Llorca
J. González-Macías
Publication date
01-01-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 1/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3219-6

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