Top

Archives of Osteoporosis

Published in:

01-12-2011 | Original Article

Serum 25-hydroxyvitamin D, bone mineral density, and non-vertebral fracture risk in community-dwelling older men: results from Mr. Os, Hong Kong

Authors: Ruth Chan, Cheong Chun Dicken Chan, Jean Woo, Claes Ohlsson, Dan Mellström, Timothy Kwok, Ping Chung Leung

Published in: Archives of Osteoporosis | Issue 1-2/2011

Abstract

Summary

The study examined vitamin D status in relation to bone mineral density (BMD) and fracture risk in older Chinese men. Vitamin D deficiency was uncommon in this sample. Higher serum vitamin D level was associated with higher baseline BMD, but was not associated with bone loss or fracture risk.

Purpose

Vitamin D status in relation to bone health and fracture risk in Asian men is unknown. This study examined how vitamin D status was associated with BMD and fracture risk in Chinese men.

Methods

The study consisted of a cross-sectional and longitudinal design (the 4-year follow-up). Subjects included 939 and 712 men aged 65 year and older for cross-sectional analysis and longitudinal analysis, respectively. Baseline serum 25-hydroxyvitamin D (25OHD) was measured by a competitive radioimmunoassay kit. Baseline and 4-year percentage change in BMD at total hip, spine, and femoral neck was examined by dual-energy X-ray absorptiometry. Data on incident non-vertebral fractures and hip fractures in 4 years were collected. Data were collected for confounding factors: demographics, smoking, alcohol use, body mass index, physical activity, diet, season of blood measurement, and serum parathyroid hormone level. Multivariate regression analyses were performed with adjustments for confounding factors.

Results

A total of 94.1% of this sample had serum 25OHD at 50 nmol/L and over. After adjustment for potential confounding factors, higher serum 25OHD level was associated with higher baseline BMD at all measured sites. No association was observed between serum 25OHD level and percentage change in BMD or risk of non-vertebral fracture or hip fracture after adjustment for confounding factors.

Conclusions

Vitamin D deficiency was not common in this sample of Chinese men. Higher serum 25OHD level was associated with higher BMD at cross-sectional level. There was no association between serum 25OHD level and bone loss or fracture risk.

Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, Fuleihan GE, Josse RG, Lips P, Morales-Torres J (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820PubMedCrossRef

Harris S (2008) Emerging roles of vitamin D: more reasons to address widespread vitamin D insufficiency. Mol Aspects Med 29:359–360PubMedCrossRef

Ho-Pham LT, Nguyen ND, Lai TQ, Eisman JA, Nguyen TV (2010) Vitamin D status and parathyroid hormone in a urban population in Vietnam. Osteoporos Int 22(1):241–248. doi:10.1007/s00198-010-1207-4 PubMedCrossRef

Hawkins RC (2009) 25-OH vitamin D3 concentrations in Chinese, Malays, and Indians. Clin Chem 55:1749–1751PubMedCrossRef

Woo J, Lam CW, Leung J, Lau WY, Lau E, Ling X, Xing X, Zhao XH, Skeaff CM, Bacon CJ, Rockell JE, Lambert A, Whiting SJ, Green TJ (2008) Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong. Br J Nutr 99:1330–1334PubMedCrossRef

Oudshoorn C, van der Cammen TJ, McMurdo ME, van Leeuwen JP, Colin EM (2009) Ageing and vitamin D deficiency: effects on calcium homeostasis and considerations for vitamin D supplementation. Br J Nutr 101:1597–1606PubMedCrossRef

MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76:1536–1538PubMedCrossRef

Konradsen S, Ag H, Lindberg F, Hexeberg S, Jorde R (2008) Serum 1, 25-dihydroxy vitamin D is inversely associated with body mass index. Eur J Clin Nutr 47:87–91CrossRef

Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281PubMedCrossRef

10.

Kulie T, Groff A, Redmer J, Hounshell J, Schrager S (2009) Vitamin D: an evidence-based review. J Am Board Fam Med JABFM 22:698–706CrossRef

11.

Ceglia L (2008) Vitamin D and skeletal muscle tissue and function. Mol Aspects Med 29:407–414PubMedCrossRef

12.

Heaney RP (2005) The vitamin D requirement in health and disease. J Steroid Biochem Mol Biol 97:13–19PubMedCrossRef

13.

Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28PubMed

14.

Lopes JB, Danilevicius CF, Takayama L, Caparbo VF, Scazufca M, Bonfa E, Pereira RM (2009) Vitamin D insufficiency: a risk factor to vertebral fractures in community-dwelling elderly women. Maturitas 64:218–222PubMedCrossRef

15.

Cauley JA, LaCroix AZ, Wu L, Horwitz M, Danielson ME, Bauer DC, Lee JS, Jackson RD, Robbins A, Wu C, Stanczyk FZ, LeBoff MS, Wactawski-Wende J, Sarto G, Ockene J, Cummings SR (2008) Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Ann Intern Med 149:242–250PubMed

16.

Pekkarinen T, Turpeinen U, Hamalainen E, Loyttyniemi E, Alfthan H, Valimaki MJ (2010) Serum 25(OH)D3 vitamin status of elderly Finnish women is suboptimal even after summer sunshine but is not associated with bone density or turnover. Eur J Endocrinol 162:183–189PubMedCrossRef

17.

von Muhlen DG, Greendale GA, Garland CF, Wan L, Barrett-Connor E (2005) Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: the Rancho Bernardo study. Osteoporos Int 16:1721–1726CrossRef

18.

Nakamura K, Tsugawa N, Saito T, Ishikawa M, Tsuchiya Y, Hyodo K, Maruyama K, Oshiki R, Kobayashi R, Nashimoto M, Yoshihara A, Ozaki R, Okano T, Yamamoto M (2008) Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi study. Bone 42:271–277PubMedCrossRef

19.

Ensrud KE, Taylor BC, Paudel ML, Cauley JA, Cawthon PM, Cummings SR, Fink HA, Barrett-Connor E, Zmuda JM, Shikany JM, Orwoll ES, Osteoporotic Fractures in Men Study G (2009) Serum 25-hydroxyvitamin D levels and rate of hip bone loss in older men. J Clin Endocrinol Metab 94:2773–2780PubMedCrossRef

20.

Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B (2004) Positive association between 25-hydroxyvitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med 116:634–639PubMedCrossRef

21.

Kuchuk NO, Pluijm SM, van Schoor NM, Looman CW, 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 94:1244–1250PubMedCrossRef

22.

van Schoor NM, Visser M, Pluijm SM, Kuchuk N, Smit JH, Lips P (2008) Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone 42:260–266PubMedCrossRef

23.

Wat WZ, Leung JY, Tam S, Kung AW (2007) Prevalence and impact of vitamin D insufficiency in southern Chinese adults. Ann Nutr Metab 51:59–64PubMedCrossRef

24.

Census and Statistics Department (2006) Hong Kong 2006 Population Bycensus Thematic Report: Older Persons. Census and Statistics Department, Hong Kong

25.

Washburn RA, Smith KW, Jette AM, Janney CA (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162PubMedCrossRef

26.

Hagiwara A, Ito N, Sawai K, Kazuma K (2008) Validity and reliability of the Physical Activity Scale for the Elderly (PASE) in Japanese elderly people. Geriatr Gerontol Int 8:143–151PubMedCrossRef

27.

Dinger MK, Oman RF, Taylor EL, Vesely SK, Able J (2004) Stability and convergent validity of the Physical Activity Scale for the Elderly (PASE). J Sports Med Phys Fitness 44:186–192PubMed

28.

Paul AA, Southgate DAT (1978) McCance & Widdowson’s: the composition of foods. HMSO, London

29.

Yang Y, Wang G, Pan X (2002) China food composition 2002. University Medical, Peking

30.

Woo J, Leung SSF, Ho SC, Lam TH, Janus ED (1997) A food frequency questionnaire for use in the Chinese population in Hong Kong: description and examination of validity. Nutr Res 17:1633–1641CrossRef

31.

Kim S, Haines PS, Siega-Riz AM, Popkin BM (2003) The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 133:3476–3484PubMed

32.

Woo J, Cheung B, Ho S, Sham A, Lam TH (2008) Influence of dietary pattern on the development of overweight in a Chinese population. Eur J Clin Nutr 62:480–487PubMedCrossRef

33.

Stookey JD, Wang Y, Ge K, Lin H, Popkin BM (2000) Measuring diet quality in China: the INFH-UNC-CH diet quality index. Eur J Clin Nutr 54:811–821PubMedCrossRef

34.

Lau EM, Leung PC, Kwok T, Woo J, Lynn H, Orwoll E, Cummings S, Cauley J (2006) The determinants of bone mineral density in Chinese men—results from Mr. Os (Hong Kong), the first cohort study on osteoporosis in Asian men. Osteoporos Int 17:297–303PubMedCrossRef

35.

Holick MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19:73–78PubMedCrossRef

36.

Hirani V, Tull K, Ali A, Mindell J (2010) Urgent action needed to improve vitamin D status among older people in England! Age Ageing 39:62–68PubMedCrossRef

37.

Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM, van Dam RM (2007) Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 261:558–565PubMedCrossRef

38.

Bakhtiyarova S, Lesnyak O, Kyznesova N, Blankenstein MA, Lips P (2006) Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporos Int 17:441–446PubMedCrossRef

39.

Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW (2008) Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 65:508–512PubMedCrossRef

40.

Milaneschi Y, Shardell M, Corsi AM, Vazzana R, Bandinelli S, Guralnik JM, Ferrucci L (2010) Serum 25-hydroxyvitamin D and depressive symptoms in older women and men. J Clin Endocrinol Metab 95:3225–3233PubMedCrossRef

41.

Kung AWC, Lee KK (2006) Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong. BMC Public Health 6:226PubMedCrossRef

42.

Department of Health (2004) Population health survey. Department of Health, Hong Kong, China

43.

El Miedany YM, Mehanna AN, El Baddini MA (2000) Altered bone mineral metabolism in patients with osteoarthritis. Joint Bone Spine 67:521–527PubMedCrossRef

44.

Dawson-Hughes B (2008) Serum 25-hydroxyvitamin D and functional outcomes in the elderly. Am J Clin Nutr 88:537S–540SPubMed

45.

Sigurdsson G, Franzson L, Steingrimsdottir L, Sigvaldason H (2000) The association between parathyroid hormone, vitamin D and bone mineral density in 70-year-old Icelandic women. Osteoporos Int 11:1031–1035PubMedCrossRef

46.

Levin A, Li YC (2005) Vitamin D and its analogues: do they protect against cardiovascular disease in patients with kidney disease? Kidney Int 68:1973–1981PubMedCrossRef

Title: Serum 25-hydroxyvitamin D, bone mineral density, and non-vertebral fracture risk in community-dwelling older men: results from Mr. Os, Hong Kong
Authors: Ruth Chan
Cheong Chun Dicken Chan
Jean Woo
Claes Ohlsson
Dan Mellström
Timothy Kwok
Ping Chung Leung
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Archives of Osteoporosis / Issue 1-2/2011
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-011-0053-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Serum 25-hydroxyvitamin D, bone mineral density, and non-vertebral fracture risk in community-dwelling older men: results from Mr. Os, Hong Kong

Abstract

Summary

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1-2/2011

Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease

Epidemiological burden of postmenopausal osteoporosis in the UK from 2010 to 2021: estimations from a disease model

Older age and lower adiposity predict better 25-hydroxy vitamin D concentration in Inuit adults: International Polar Year Inuit Health Survey, 2007–2008

Femoral neck bone mineral density and 10-year absolute fracture risk in a national representative sample of Bulgarian women aged 50 years and older

Influence of menopause on mandibular bone quantity and quality in Japanese women receiving dental implants

Osteoporosis: burden, health care provision and opportunities in the EU