Optimal Serum Concentration of 25-Hydroxyvitamin D for Bone Health in Older Korean Adults

Background: 25-hydroxyvitamin-D (25[OH]D) and Dual-energy x-ray absorptiometry (DEXA) are routinely evaluated in bone health clinics, but existing literature is conflicting with regard to whether these factors predict fragility fractures. We hypothesized that both serum 25(OH)D levels and bone density are lower in patients who have sustained fragility fracture(s) prior to initial presentation compared to those patients who have not. Methods: We reviewed the charts of 102 consecutive patients presenting to a single-center Bone Health Clinic, comprising 11 males and 91 females with a mean age of 68 and range of 50 to 92. Demographic data, serum 25(OH)D levels, fracture history, and DEXA scans were obtained at the initial visit. Results: 64 patients had previously sustained a fragility fracture, and 38 patients had not. 25(OH)D levels were similar in the fracture and non-fracture groups (37.12±17.02 ng/mL versus 38.55±16.42, p=0.676). DEXA T-scores were similar between fracture and non-fracture groups (-2.28±1.33 versus -1.82±1.1, p=0.075). Patients with rheumatoid arthritis (RA) (n=7) had lower 25(OH)D levels upon presentation (mean 22.57±8.46 versus 38.77±16.67, p=0.001). BMI was inversely correlated with 25(OH)D level (Pearson correlation [R] =-0.211, p=0.033). Age was inversely correlated with DEXA T-score (R=-0.269, p-0.009), whereas BMI was positively correlated with DEXA T-score (R=0.259, p=0.013). The other demographic variables and risk factors studied were not significantly associated with either 25(OH)D levels or DEXA T-scores. Within the fracture group, DEXA T-scores were lower for patients who had sustained a hip fracture (n=15) compared to those who had sustained a fragility fracture elsewhere (-3.12±1.02 versus -2.03±1.32, p=0.004), but their 25(OH)D levels did not differ (34.33±25.49 versus 37.98±13.69, p=0.602). Conclusions: In this cohort of patients referred to a Bone Health Clinic, serum 25(OH)D levels and DEXA T-scores did not differ between those patients who had sustained a fragility fracture from those who had not.

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A Comparison of Free and Total 25-hydroxyvitamin D Levels as Functional Indicators of Bone Health in Healthy Children

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.548 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A270-A270

Author(s):

You Joung Heo ◽

Yun Jeong Lee ◽

Kyunghoon Lee ◽

Jae Hyun Kim ◽

Choong Ho Shin ◽

...

Keyword(s):

Vitamin D ◽

Bone Health ◽

Normal Weight ◽

Healthy Children ◽

Vitamin D Metabolites ◽

Dihydroxyvitamin D3 ◽

Bone Parameters ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

24,25 Dihydroxyvitamin D3

Abstract Abstract Context: The “free hormone” hypothesis suggests that the free 25-hydroxyvitamin D (25OHDFree) level may usefully indicate bone health. Objective: To determine which vitamin D measure is optimally correlated with clinical and bone parameters in healthy children. Design and Participants: A cross-sectional study including 146 healthy children (71 boys, 9.5±1.9 years) at a tertiary medical center. Main Outcome Measures: We used a multiplex liquid chromatography-tandem mass spectrometry-based assay to simultaneously measure vitamin D metabolites. The 25OHDFree level was directly measured (m-25OHDFree) or calculated using genotype-constant or genotype-specific affinity coefficients of vitamin D-binding proteins (con-25OHDFree or spe-25OHDFree). Bone mineral content (BMC) and density (BMD) were assessed via dual-energy X-ray absorptiometry. Results: The concentrations of total 25OHD (25OHDTotal), the three forms of 25OHDFree, and 24,25-dihydroxyvitamin D3 correlated with parathyroid hormone levels (all p<0.01). Serum 25OHDTotal and m-25OHDFree levels reflected age, puberty, season, body mass index (BMI), daylight hours, and vitamin D intake (all p<0.05). The con-25OHDFree level better reflected puberty and daylight hours than did the spe-25OHDFree level (both p<0.01). The association between the 25OHDTotal level and bone parameters varied according to the BMI (interaction p<0.05). In 109 normal-weight children, the con-25OHDFree level correlated with BMC and BMD (both p<0.05), but the 25OHDTotal and 24,25-dihydroxyvitamin D3 levels were associated with BMC (both p<0.05). No association was found in overweight or obese children. Conclusions: In healthy children, total and free 25OHD levels comparably reflected lifestyle factors. In normal-weight children, the con-25OHDFree level reflected BMC and BMD, whereas the 25OHDTotal level was associated with BMC.

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Association between Serum 25-Hydroxyvitamin D Levels and Cardiometabolic Risk Factors in Young Korean Adults

Korean Journal of Family Practice ◽

10.21215/kjfp.2018.8.6.841 ◽

2018 ◽

Vol 8 (6) ◽

pp. 841-847

Author(s):

Shorry Lea ◽

Miso Jang ◽

Yeji Kim ◽

Hee-Kyung Joh ◽

Cheol Min Lee ◽

...

Keyword(s):

Risk Factors ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Hydroxyvitamin D ◽

Korean Adults ◽

25 Hydroxyvitamin D

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Vitamin D and Bone Health—Discussion Points Following the Recent Institute of Medicine Recommendations

US Endocrinology ◽

10.17925/use.2011.07.02.137 ◽

2011 ◽

Vol 07 (02) ◽

pp. 137 ◽

Cited By ~ 1

Author(s):

Robert P Heaney ◽

Keyword(s):

Vitamin D ◽

Bone Health ◽

Calcium Absorption ◽

Institute Of Medicine ◽

Vitamin D Status ◽

Extensive Experience ◽

Hydroxyvitamin D ◽

Daily Amount ◽

Fracture Risk Reduction ◽

25 Hydroxyvitamin D

The 2011 Institute of Medicine recommendations for vitamin D—both the recommended daily amount (RDA) and the vitamin D status judged adequate for bone health—are too low. Calcium absorption, osteoporotic fracture risk reduction, and healing of histological osteomalacia all require values above 30 ng/ml, and probably even 40 ng/ml. Furthermore, the proposed RDA (600 international units per day up to the age of 70) is not compatible with the blood level of 25-hydroxyvitamin D (i.e., 20 ng/ml) recommended in the same report. Concerns regarding adverse consequences of higher intakes or status levels can be dismissed, in view of our extensive experience with outdoor summer workers (who regularly have values of 60 ng/ml or more) and the virtual certainty that human physiology evolved in—and is attuned to—an environment providing 10,000 IU/day or more.

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Vitamin D Binding Protein Genotype Is Associated with Serum 25-Hydroxyvitamin D and PTH Concentrations, as Well as Bone Health in Children and Adolescents in Finland

PLoS ONE ◽

10.1371/journal.pone.0087292 ◽

2014 ◽

Vol 9 (1) ◽

pp. e87292 ◽

Cited By ~ 27

Author(s):

Minna Pekkinen ◽

Elisa Saarnio ◽

Heli T. Viljakainen ◽

Elina Kokkonen ◽

Jette Jakobsen ◽

...

Keyword(s):

Vitamin D ◽

Children And Adolescents ◽

Bone Health ◽

Binding Protein ◽

Vitamin D Binding Protein ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Protein Genotype

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Familial hypocalciuric hypercalcaemia: observations on vitamin D metabolism and parathyroid function

Acta Endocrinologica ◽

10.1530/acta.0.1040210 ◽

1983 ◽

Vol 104 (2) ◽

pp. 210-215 ◽

Cited By ~ 16

Author(s):

M. Davies ◽

P. H. Adams ◽

J. L. Berry ◽

G. A. Lumb ◽

P. S. Klimiuk ◽

...

Keyword(s):

Vitamin D ◽

Serum Concentration ◽

Primary Hyperparathyroidism ◽

Calcium Excretion ◽

Renal Tubules ◽

Vitamin D Metabolites ◽

Vitamin D Metabolism ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Renal Tubular

Abstract. Serum vitamin D metabolites, the renal tubular maximum reabsorptive rate for phosphate (TMP/GFR) nephrogenic cyclic AMP (NcAMPI, and CaE (urinary calcium excretion per litre of glomerular filtrate) were measured in 14 adults with familial hypocalciuric hypercalcaemia (FHH). The findings were compared with analyses in 14 patients with surgically proven primary hyperparathyroidism matched for serum calcium, creatinine clearance and vitamin D status (assessed by serum concentrations of 25 hydroxyvitamin D). Vitamin D metabolites were also measured in 16 normocalcaemic relatives of patients with FHH. The serum concentration of 24, 25 dihydroxycholecalciferol was appropriate for the prevailing 25 hydroxyvitamin D and no difference was found between groups. The serum concentration of 1, 25 dihydroxycholecalciferol was significantly greater in primary hyperparathyroidism (P < 0.0005) compared with patients with FHH and their normocalcaemic relatives. TMP/GFR was reduced in both primary hyperparathyroidism (0.53 ± 0.12 mmol/l GF, mean ± sem) and FHH (0.86 ±0.14 mmol/l GF). Patients with primary hyperparathyroidism showed an increase in NcAMP output in the urine (38.5 ± 16 mmol/l GF) which was significantly greater (P < 0.0001) than the normal NcAMP (13.5 ± 9.2 nmol/l GF) found in FHH. CaE was low in FHH indicating increased renal tubular reabsorption of calcium. It is concluded that there is no abnormality of vitamin D metabolism in FHH comparable with the changes observed in primary hyperparathyroidism. It is suggested that the biochemical abnormalities in FHH cannot be explained solely upon an increased sensitivity of the renal tubules to the effects of endogenous parathyroid hormone.

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