scholarly journals MON-387 Association Between Vitamin D Level and Bone Mineral Density in Korean Adolescents

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Kyungchul Song ◽  
Han saem CHOI ◽  
Junghwan Suh ◽  
Ah Reum Kwon ◽  
Hyun-wook Chae ◽  
...  

Abstract Introduction Fractures are common in pediatric population, and lower bone density increases the risk of fracture. Most bone acquisition happens during youth, so juvenile bone mineral density (BMD) assessment is important. There are many factors associated with low BMD, including vitamin D status, calcium intake, low body weight, and physical activity. Among these, our investigation focused on the association of BMD with vitamin D in adolescents. Methods This study investigated data of 1,063 adolescents aged 12-18 years from the fifth and sixth Korea National Health and Nutritional Examination Survey (2009-2011). The association of various factors (vitamin D level, calcium intake, body mass index (BMI), lean mass, fat mass, and physical activity) with BMD Z-scores in whole body, lumbar spine, total femur, and femur neck were analyzed. We defined vitamin D deficiency (≤ 12 ng/mL), vitamin D insufficiency (12-20 ng/mL), and sufficiency (> 20ng/mL) according to the 25-hydroxyvitamin D (25-OHD) level. We analyzed association between BMD and vitamin D levels after adjusting for other factors. Results The mean 25-OHD level of subjects was low (16.28 ng/ml). Of all subjects, 21.9% were vitamin D deficient, and 58.5% were vitamin D insufficient. Among the vitamin D groups, the vitamin D sufficient group had significantly higher BMD Z-scores than the vitamin D deficient group in whole body, lumbar spine, and femur neck. The sufficient vitamin D group had higher BMD Z-score than the vitamin D insufficient group in femur neck, and the vitamin D insufficient group had higher BMD Z-score than the vitamin D deficient group in whole body. Among various factors, vitamin D status, calcium intake, BMI, lean mass, fat mass, and physical activity were positively associated with BMD Z-scores. In particular, lean mass was the strongest independent factor. Vitamin D levels were positively associated with the BMD Z-scores even after adjusting for other factors. Conclusions Vitamin D deficiency and insufficiency were common among adolescents. This study suggested that vitamin D level was positively associated with BMD, and that sufficient vitamin D level was needed to prevent low BMD. Vitamin D status is an important factor of BMD in adolescents.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4472-4472
Author(s):  
Amy Garee ◽  
Micah Skeens ◽  
Sasigarn Bowden ◽  
Manmohan Kamboj ◽  
Sally Wildman ◽  
...  

Abstract Abstract 4472 Introduction: Children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of developing vitamin D deficiency (VDD). However, data on vitamin D status and its correlation with bone mineral density (BMD) in the long term survivors after childhood HSCT is limited. The aim of this study was to determine the prevalence of VDD among long term survivors after HSCT in childhood, and to evaluate the correlations between vitamin D and BMD. Methods: A retrospective study was carried out in patients seen in Long Term follow-up Clinic (LTFC) at our institution from January 2011 to July 2012. Vitamin D deficiency (VDD) and insufficiency (VDI) were defined as serum 25-hydroxyvitamin D (25-OHD) <15 ng/mL and 15–30 ng/mL, respectively. BMD was measured using dual-energy radiograph absorptiometry (Hologic Delphi). Lumbar, total body, and hip BMD Z scores were determined using manufacturer's normative data based on age. Spearman's correlation was performed to assess correlation between serum 25-OHD levels and different BMD variables. Results: Ninety eight patients underwent 103 HSCTs between 1990 and 2010. Fifty two (53%) patients were > 5 years out of transplant. A total of 114 vitamin D levels were recorded for the 98 patients, the median 25-OHD level was 26 (range 7 – 68 ng/mL). In 68/114 (60%) observations the 25-OHD levels were less than < 30ng/mL. Of these, 10 (9%) patients had VDD (levels < 15ng/mL, while 58 (51%) had VDI. There were no significant correlations between 25-OHD levels and age at HSCT, gender, underlying diagnosis, type of transplant, or development of acute or chronic GVHD (Table 2). There was a trend towards lower 25-OHD levels after non-TBI based conditioning regimen (p = 0.047). BMD was performed in 83 patients (85%). Low BMD was found in nearly one-third to half of patients tested: 29%, 54%, and 33% of the patients had BMDlumbar, BMDhip and BMDWB Z scores of < −1.0, respectively, while 5%, 9% and 5% of the patients had BMDlumbar, BMDhip and BMDWB Z scores < −2.5, respectively. The median Z scores of the BMDlumbar, BMDhip, and the BMDWB were −0.3 (range −4.2 to 2.4), −1.1 (range −3.3 to 1.9), and −0.4 (range −5.4 to 2.7) respectively. In patients with BMD < −2.5 and < −1.0, the corresponding median 25-OHD was 26 (range 7 – 62 ng/mL) and there was no significant association. Spearman correlation between 25-OHD D level, BMDWB and BMDlumbar showed a correlation coefficient of −0.24 (p value: 0.0409) and −0.22 (p value: 0.0546) respectively. There was no correlation between normal vitamin D levels, VDI and VDD with BMD of the hip, lumbar spine and whole body. Discussion: Low 25-OHD (<30ng/mL) was common (60%) in long term survivors after HSCT during childhood. Similar to other reports, VDD and VDI was seen in 9%, and 51% of the patients respectively. There was only a weak correlation of the 25-OHD levels with BMD of whole body and the lumbar spine, suggesting that factors other than hypovitaminosis D might have contributed to low BMD. There was a small trend of lower 25-OHD levels after non-TBI based conditioning. Disclosures: No relevant conflicts of interest to declare.


2020 ◽  
Author(s):  
Chung Yuan Chang ◽  
Kanimolli Arasu ◽  
Soon Yee Wong ◽  
Shu Hwa Ong ◽  
Wai Yew Yang ◽  
...  

Abstract Background: Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods: Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results: The mean calcium intake was 348.8 ± 180.1 mg/day and mean serum 25-OH vitamin D level was 43.9 ± 14.5nmol/L. In boys, lean mass (LM) was significantly associated with LSBMC (β = 0.539, p<0.001), LSBMD (β=0.607, p<0.001), TBBMC (β=0.675, p<0.001) and TBBMD (β= 0.481, p<0.01). Height was significantly associated with LSBMC (β =0.346, p<0.001) and TBBMC (β =0.282, p<0.001) while fat mass (FM) (β=0.261, p=0.034) and MET score (β =0.163, p=0.026) were significant predictors of TBBMD. Among girls, LM was significantly associated with LSBMC (β = 0.620, p<0.001), LSBMD (β=0.700, p<0.001), TBBMC (β=0.542, p<0.001) and TBBMD (β= 0.747, p<0.001). Calcium intake was a significant predictor of LSBMC (β=0.102, p=0.034), TBBMC (β=0.122, p<0.001) and TBBMD (β=0.196, p=0.002) in girls. Lean mass (LM) was weakly correlated with MET scores (r = 0.205, p = 0.001) but not protein (r = 0.055, p = 0.393) or energy intake (r = 0.101, p = 0.117). MET score (β = 0.207, p = 0.043) was a significant predictor of LM in boys but no factor was found to predict LM in girls. Conclusion: LM is the major determinant of BMC and BMD among pre-adolescent Malaysian children and physical activity is a significant predictor of LM in boys. Encouraging physical activity, calcium intake and optimum diets that build lean body mass should be the focus for developing public health guidance to ensure optimal bone health status during rapid growth.


2014 ◽  
Vol 58 (5) ◽  
pp. 572-582 ◽  
Author(s):  
Marília Brasilio Rodrigues Camargo ◽  
llda Sizue Kunii ◽  
Lilian Fukusima Hayashi ◽  
Patrícia Muszkat ◽  
Catherine Gusman Anelli ◽  
...  

Objectives To evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian osteoporotic patients and the modifiable factors of vitamin D status in this population. Subjects and methods In a cross-sectional study, 363 community-dwelling patients who sought specialized medical care were evaluated between autumn and spring in São Paulo, Brazil. Serum levels of 25(OH)D and parathormone (PTH), biochemical and anthropometric measurements, and bone density scans were obtained. The group was assessed using two questionnaires: one questionnaire covered lifestyle and dietary habits, skin phototype, sun exposure, medical conditions, and levels of vitamin D supplementation (cholecalciferol); the other questionnaire assessed health-related quality-of-life. Logistic regression and a decision tree were used to assess the association between the variables and the adequacy of vitamin D status. Results The mean age of the overall sample was 67.9 ± 8.6 years, and the mean 25(OH)D concentration was 24.8 ng/mL. The prevalence of inadequate vitamin D status was high (73.3%), although 81.5% of the subjects were receiving cholecalciferol (mean dose of 8,169 IU/week). 25(OH)D was positively correlated with femoral neck bone mineral density and negatively correlated with PTH. In the multivariate analysis, the dose of cholecalciferol, engagement in physical activity and the month of the year (September) were associated with improvement in vitamin D status. Conclusions In this osteoporotic population, vitamin D supplementation of 7,000 IU/week is not enough to reach the desired 25(OH)D concentration (≥ 30 ng/mL). Engagement in physical activity and the month of the year are modifiable factors of the vitamin D status in this population.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Maria Nikolova ◽  
Alexander Penkov

AbstractIntroduction:Obesity has been linked with vitamin D deficiency in a number of cross-sectional studies, reviews and meta-analyses. To assess the correlations of plasma 25(OH) vitamin D levels with indices of body composition examined by DXA with an emphasis on lean and bone mass as well as on indices such as android/gynoid fat, appendicular lean mass (ALM) and appendicular lean mass index (ALMI), fat-mass indexes (FMI), fat-free mass indexes (FFMI) and the ALM-to-BMI index.Materials and Methods:62 adult subjects consented to participate – 27 men (43.5 %) and 35 women (56.5 %). Their mean age was 45.3 ± 9.5 years. Fan-beam dual-energy X-ray (DXA) body composition analysis was performed on a Lunar Prodigy Pro bone densitometer with software version 12.30. Vitamin D was measured by electro-hemi-luminescent detection as 25(OH)D Total (ECLIA, Elecsys 2010 analyzer, Roche Diagnostics). Statistical analyses were done using the SPSS 23.0 statistical package.Results:The serum 25(OH)D level was correlated significantly only to the whole body bone mineral content, the appendicular lean mass index (ALMI) and the ALM-to-BMI index, underlining a predominant role for lean and fat-free mass. Vitamin D showed a very weak correlation to % Body Fat and the Fat Mass Index (FMI) in men only. Moreover, the multiple regression equation including the associated parameters could explain only 7 % of the variation in the serum 25(OH)D levels.Discussion:Our conclusion was, that there are differences in the associations of the vitamin D levels with the different body composition indices, but these associations are generally very weak and therefore – negligible.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Juanita K Hodax ◽  
Charles Brady ◽  
Sara A DiVall ◽  
Kristen Carlin ◽  
Hedieh Khalatbari ◽  
...  

Abstract Background Sex steroids such as testosterone and estrogen are necessary for accumulation of bone mass. Transgender youth treated with gonadotropin releasing hormone analogues (GnRHa) to block natal puberty for gender-affirming care are at risk of low bone mineral density (BMD). Previous studies indicate that transfemale patients assigned male at birth (AMAB) have low BMD at baseline, during and after GnRHa treatment despite cross hormone treatment. Transmales assigned female at birth (AFAB), however, have normal BMD at baseline that decreases upon GnRHa treatment, with normalization upon cross hormone therapy. The reason(s) for the low baseline BMD in transfemales is unclear. We aimed to assess the baseline characteristics of transgender youth at a single multidisciplinary gender clinic prior to medical intervention and determine factors associated with BMD. Methods This is a retrospective chart review of patients &lt;19 years old evaluated in the gender clinic. Dual-energy x-ray absorptiometry (DXA) scans were obtained prior to initiation of GnRHa or cross-hormone therapy per Endocrine Society guidelines for the treatment of gender dysphoria. We included patients with DXA scans completed prior to initiation of treatment with GnRHa or cross gender hormones and excluded those with concurrent medical diagnoses that may affect bone density. Data collected were bone mineral density (BMD) Z-scores, anthropometric data, vitamin D and calcium levels, and calcium intake. Multivariable linear regression models were used to assess the impact of vitamin D levels, height Z-score, weight Z-score, and BMI Z-score on subtotal body BMD Z-score, adjusted for sex assigned at birth and age. Results Sixty-four patients were included in our analysis. Of these, 73% were AMAB and 27% AFAB. Gender identity was male in 14%, female in 44%, and non-binary in 42%. Average height Z-score was 0.12, weight Z-score 0.27, and BMI Z-score 0.22 (using sex assigned at birth). Subtotal body BMD Z-scores were greater than zero in 11%, between zero and greater than -2 in 59%, and less than or equal to -2 in 30% of tested patients. AMAB patients had lower BMD Z-scores compared to those AFAB (p&lt;0.05 for all Z-scores). There was a positive association with BMI, height, and weight Z-scores and increasing BMD Z-scores after adjusting for sex assigned at birth and age (p&lt;0.05 for all Z-scores). Patients who consumed &lt;2 servings of calcium per day had lower BMD Z-scores (p&lt;0.05 for all Z-scores). Average vitamin D level was 24 ng/ml (+/- 9.5 SD) with no significant association with BMD Z-scores (adjusted for sex assigned at birth). Conclusions Patients AMAB and patients with calcium intake of &lt; 2 servings/day are associated with lower baseline BMD in a cohort of adolescents seen in a multidisciplinary gender clinic. Height, weight, and BMI are associated linearly with BMD Z-score, following patterns previously described in other populations.


2021 ◽  
Author(s):  
Ursula Pia Ferrara ◽  
Cristina Tortora ◽  
Carmen Rosano BD ◽  
Antonia Assunto BD ◽  
Alessandro Rossi ◽  
...  

Abstract Bone metabolism has been rarely investigated in children affected by Neurofibromatosis (NF1). Aim of the present study was to assess bone mineral metabolism in children and adults NF1 patients, to determine the relevant factors potentially involved in the development of reduced bone mineral density (BMD), and provide possible therapeutic intervention in NF1 patients. 114 NF1 patients and sex and age matched controls were enrolled into the study. Clinical and biochemical factors reflecting bone metabolism were evaluated. Factors potentially affecting BMD were also investigated including: physical activity, sun exposure, vitamin D intake. Whenever the presence of vitamin D deficiency was recorded, cholecalciferol supplementation was started and BMD data obtained during supplementation were compared with previous ones. NF1 patients showed lower Z-scores at Dual-Energy X-ray Absorptiometry (DXA) than controls. Physical activity was significantly reduced in NF1 patients than in controls. Sun exposure was significantly lower in NF1 compared to control subjects. At linear regression analysis vitamin D was the most predictive factor of reduced BMD (p = 0.0001). Cholecalciferol supplementation significantly increased BMD z.score (p = 0.000). We speculated that a combination of different factors, including reduced sun exposure, possibly associated with reduced serum vitamin D levels, and poor physical activity, concur to the impaired bone status in NF1 patients. We also demonstrated that treatment with vitamin D can be effective in improving BMD in NF1 patients, including children. In conclusion, the findings of the current study are expected to have important implications for the follow-up and prevention of osteopenia/osteoporosis in this common genetic disease.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Maryam Razaghi ◽  
Catherine Vanstone ◽  
Olusola Sotunde ◽  
Nathalie Gharibeh ◽  
Sarah Kimmins ◽  
...  

Abstract Objectives Vitamin D status is positively associated with lean mass phenotype in healthy infants born with sufficient vitamin D stores. The objective is to test whether rapid correction of low neonatal vitamin D status improves body composition (lean mass and fat mass) at 6 mo of age. Methods In a double-blinded randomized parallel group controlled trial (NCT02563015), healthy term neonates of appropriate weight for gestational age were recruited from Montreal. Capillary blood samples were collected 24–36 h post natally for measurement of serum 25-hydroxyvitamin D [25(OH)D] (Liaison, Diasorin Inc.). Infants with serum 25(OH)D < 50 nmol/L (n = 87) were randomized to receive 400 or 1000 IU/d until 6 mo of age. Those with 25(OH)D ≥ 50 nmol/L (n = 31) were recruited as a reference group, and received 400 IU/d. Anthropometry, lean mass and fat mass (dual-energy x-ray absorptiometry) were measured at baseline, 3 and 6 mo. Skin color was measured using a spectrophotometer. Differences between treatments and reference groups were tested using mixed model and repeated measures ANOVA accounting for the effects of sex, season of birth, skin color and gestational age (GA). Results Neonates (67 males, 51 females) were 39.6 ± 1wk GA and 3387 ± 371 g at birth. There were no differences between groups in lean mass or fat mass at baseline; nor in weight or length at any time-point. Combined treatment groups, had lower serum 25(OH)D concentrations at birth compared to the reference group (33 ± 11 vs. 69 ± 13 nmol/L, P < 0.0001). However, at 6 mo of age, serum 25(OH)D concentration was higher in the group receiving 1000 IU/d (n = 34), in comparison to the group receiving 400 IU/d (n = 29), and the reference (n = 19) group (125.0 ± 34.0, 82.2 ± 21.5 vs. reference 85.4 ± 32.1 nmol/L, P < 0.0001). Whole body lean mass was significantly different among groups (5071.3 ± 750.0, 4944.1 ± 616.3 and 5166.0 ± 645.4 g, respectively, P = 0.03), with infants in the treatment group provided a 400 IU/d supplement having a lower lean mass by 6 mo of age compared to the 1000 IU/d group. Fat mass was not different among groups following post-hoc testing (2967.0 ± 929.0 and 2962.0 ± 952.0, 2742.0 ± 754.0 g, P = 0.16). Conclusions Higher dosage supplementation of vitamin D rapidly improved vitamin D status and supported a leaner body phenotype in infancy. Funding Sources Canadian Institutes of Health Research.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 804-804
Author(s):  
Maryam Razaghi ◽  
Catherine A Vanstone ◽  
Nathalie Gharibeh ◽  
Olusola F Sotunde ◽  
Shuqin Wei ◽  
...  

Abstract Objectives The primary objective was to test whether rapid correction of insufficient vitamin D status initiated in the neonatal period improves whole-body lean mass across infancy. Methods This was a double-blinded, parallel-group, randomized controlled trial (NCT02563015). Healthy term breastfed infants of appropriate weight for gestational age (AGA) were recruited from Montreal (March 2016–2019). Capillary blood was collected (24–36 h) for serum 25-hydroxyvitamin D [25(OH)D] measurement (Liaison, Diasorin Inc.). Infants with serum 25(OH)D &lt; 50 nmol/L were randomized to receive 400 (group 1, n = 49) or 1000 IU/d (group 2, n = 49) until 12 mo of age. Those with 25(OH)D ≥ 50 nmol/L were recruited to form a reference group, receiving 400 IU/d (group 3, n = 41). Anthropometry, body composition (dual-energy x-ray absorptiometry), and 25(OH)D concentrations were assessed at 1, 3, 6, and 12 mo. Differences between trial and reference groups were tested using mixed model repeated measures ANOVA adjusting for maternal pregnancy weight gain, infant sex, skin color, actual age at assessment, and breastfeeding status. Data are mean ± SD. Results Infants (81 males, 58 females) were 39.6 ± 1.0 wk GA and 3388 ± 372 g at birth. By design, infants in group 1 and 2 had lower serum 25(OH)D concentrations at birth compared to group 3 (31.1 ± 9.3, 34.4 ± 12.0 vs. 68.0 ± 13.2 nmol/L, respectively, P &lt; 0.0001). On average, both trial groups achieved and maintained vitamin D sufficiency (25(OH)D ≥ 50 nmol/L) from 3 to 12 mo. Lean mass was not different among groups at baseline, but at 12 mo was higher in group 2 compared to group 1 (7012.5 ± 904.6 vs. 6690.4 ± 1121.7 g, P = 0.0075; 4.8% difference), and not different from the reference group (7012.5 ± 904.6 vs. 6715.1 ± 784.6 g, P = 0.2882). Weight, length, and whole-body fat mass were not different among groups at any time-point. Conclusions Vitamin D supplementation (400 and 1000 IU/d) corrects insufficient stores, whereas the higher dosage of 1000 IU/d, modestly increases lean mass of otherwise healthy AGA term born infants by 12 mo of age without altering weight or length. These data concur with observations in weanling rats where increased vitamin D intakes elevated lean mass. The long-term benefits require further research. Funding Sources Funded by Canadian Institutes of Health Research.


Sign in / Sign up

Export Citation Format

Share Document