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Osteoporosis International

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01-09-2020 | Osteoporosis | Original Article

The relationship of 25-hydroxyvitamin D values and risk of fracture: a population-based retrospective cohort study

Authors: A. J. Aul, D. V. Dudenkov, K. C. Mara, Y. J. Juhn, C. I. Wi, J. A. Maxson, T. D. Thacher

Published in: Osteoporosis International | Issue 9/2020

Abstract

Summary

Our study investigates 25-hydroxyvitamin D levels and fracture risk using population-level data. 25-Hydroxyvitamin D values < 12, 12–19, and > 50 ng/mL were not associated with increased risk of fractures overall compared with values 20–50 ng/mL. Severely low levels may be associated with increased risk of osteoporotic fracture, particularly of the wrist.

Introduction

Studies of the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and fracture risk have been inconsistent. We hypothesized that high 25(OH)D concentrations (> 50 ng/mL) would be associated with increased risk of fracture.

Methods

We identified all adult patients living in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2011, who had at least one 25(OH)D measurement. Fracture outcomes were retrieved starting 30 days after 25(OH)D measurement and until patients’ final clinical visit as an Olmsted County resident, December 31, 2014, or death. Data were analyzed using Cox proportional hazard regression.

Results

Of 11,002 individuals with a 25(OH)D measurement, 5.8% had a 25(OH)D value ˂ 12 ng/mL, and 5.1% had a value > 50 ng/mL. Compared with subjects with 25(OH)D values 20–50 ng/mL (reference group), values < 12, 12–19, and > 50 ng/mL displayed no association with overall fracture risk. After adjusting for a prior diagnosis of osteoporosis/osteopenia, only individuals with values ˂ 12 ng/mL had increased risk of any osteoporotic fracture (aHR = 1.41; 95% CI 1.05–1.89) and wrist fracture (aHR = 2.11; 95% CI 1.27–3.48) compared with the reference group. Compared with the reference group, values ˂ 12 ng/mL were associated with increased risk of any fracture (aHR = 1.35; 95% CI 1.01–1.80), osteoporotic fracture (aHR = 2.18; 95% CI 1.44–3.31), and wrist fracture (aHR = 2.39; 95% CI 1.19–4.81) in subjects without a prior diagnosis of osteoporosis/osteopenia, but not in those with a prior diagnosis of osteoporosis/osteopenia.

Conclusion

Severely low 25(OH)D levels may be associated with increased risk of osteoporotic fracture, particularly of the wrist, but 25(OH)D values > 50 ng/mL were not associated with increased fracture risk.

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Title: The relationship of 25-hydroxyvitamin D values and risk of fracture: a population-based retrospective cohort study
Authors: A. J. Aul
D. V. Dudenkov
K. C. Mara
Y. J. Juhn
C. I. Wi
J. A. Maxson
T. D. Thacher
Publication date: 01-09-2020
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Osteoporosis International / Issue 9/2020
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05436-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The relationship of 25-hydroxyvitamin D values and risk of fracture: a population-based retrospective cohort study

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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