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Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture.
J Bone Miner Res. 2015 Aug; 30(8):1403-13.JB

Abstract

Relationships between 1,25-dihydroxyvitamin D (1,25(OH)2 D) and skeletal outcomes are uncertain. We examined the associations of 1,25(OH)2 D with bone mineral density (BMD), BMD change, and incident non-vertebral fractures in a cohort of older men and compared them with those of 25-hydroxyvitamin D (25OHD). The study population included 1000 men (aged 74.6 ± 6.2 years) in the Osteoporotic Fractures in Men (MrOS) study, of which 537 men had longitudinal dual-energy X-ray absorptiometry (DXA) data (4.5 years of follow-up). A case-cohort design and Cox proportional hazards models were used to test the association between vitamin D metabolite levels and incident nonvertebral and hip fractures. Linear regression models were used to estimate the association between vitamin D measures and baseline BMD and BMD change. Interactions between 25OHD and 1,25(OH)2 D were tested for each outcome. Over an average follow-up of 5.1 years, 432 men experienced incident nonvertebral fractures, including 81 hip fractures. Higher 25OHD was associated with higher baseline BMD, slower BMD loss, and lower hip fracture risk. Conversely, men with higher 1,25(OH)2 D had lower baseline BMD. 1,25(OH)2 D was not associated with BMD loss or nonvertebral fracture. Compared with higher levels of calcitriol, the risk of hip fracture was higher in men with the lowest 1,25(OH)2 D levels (8.70 to 51.60 pg/mL) after adjustment for baseline hip BMD (hazard ratio [HR] = 1.99, 95% confidence interval [CI] 1.19-3.33). Adjustment of 1,25(OH)2 D data for 25OHD (and vice versa) had little effect on the associations observed but did attenuate the hip fracture association of both vitamin D metabolites. In older men, higher 1,25(OH)2 D was associated with lower baseline BMD but was not related to the rate of bone loss or nonvertebral fracture risk. However, with BMD adjustment, a protective association for hip fracture was found with higher 1,25(OH)2 D. The associations of 25OHD with skeletal outcomes were generally stronger than those for 1,25(OH)2 D. These results do not support the hypothesis that measures of 1,25(OH)2 D improve the ability to predict adverse skeletal outcomes when 25OHD measures are available. © 2015 American Society for Bone and Mineral Research.

Authors+Show Affiliations

Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA. Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA.Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA. Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA. Research Service, Portland Veterans Affairs Medical Center, Portland, OR, USA.California Pacific Medical Research Institute, San Francisco, CA, USA.Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium.Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium.Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium. Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium.Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA. Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA. Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25707402

Citation

Swanson, Christine M., et al. "Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 30, no. 8, 2015, pp. 1403-13.
Swanson CM, Srikanth P, Lee CG, et al. Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. J Bone Miner Res. 2015;30(8):1403-13.
Swanson, C. M., Srikanth, P., Lee, C. G., Cummings, S. R., Jans, I., Cauley, J. A., Bouillon, R., Vanderschueren, D., Orwoll, E. S., & Nielson, C. M. (2015). Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 30(8), 1403-13. https://doi.org/10.1002/jbmr.2487
Swanson CM, et al. Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. J Bone Miner Res. 2015;30(8):1403-13. PubMed PMID: 25707402.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. AU - Swanson,Christine M, AU - Srikanth,Priya, AU - Lee,Christine G, AU - Cummings,Steven R, AU - Jans,Ivo, AU - Cauley,Jane A, AU - Bouillon,Roger, AU - Vanderschueren,Dirk, AU - Orwoll,Eric S, AU - Nielson,Carrie M, AU - ,, Y1 - 2015/05/22/ PY - 2014/09/16/received PY - 2015/02/06/revised PY - 2015/02/18/accepted PY - 2015/2/25/entrez PY - 2015/2/25/pubmed PY - 2016/5/18/medline KW - 1,25-DIHYDROXYVITAMIN D KW - 25-HYDROXYVITAMIN D KW - BONE MINERAL DENSITY (BMD) KW - CALCITRIOL KW - FRACTURE SP - 1403 EP - 13 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 30 IS - 8 N2 - Relationships between 1,25-dihydroxyvitamin D (1,25(OH)2 D) and skeletal outcomes are uncertain. We examined the associations of 1,25(OH)2 D with bone mineral density (BMD), BMD change, and incident non-vertebral fractures in a cohort of older men and compared them with those of 25-hydroxyvitamin D (25OHD). The study population included 1000 men (aged 74.6 ± 6.2 years) in the Osteoporotic Fractures in Men (MrOS) study, of which 537 men had longitudinal dual-energy X-ray absorptiometry (DXA) data (4.5 years of follow-up). A case-cohort design and Cox proportional hazards models were used to test the association between vitamin D metabolite levels and incident nonvertebral and hip fractures. Linear regression models were used to estimate the association between vitamin D measures and baseline BMD and BMD change. Interactions between 25OHD and 1,25(OH)2 D were tested for each outcome. Over an average follow-up of 5.1 years, 432 men experienced incident nonvertebral fractures, including 81 hip fractures. Higher 25OHD was associated with higher baseline BMD, slower BMD loss, and lower hip fracture risk. Conversely, men with higher 1,25(OH)2 D had lower baseline BMD. 1,25(OH)2 D was not associated with BMD loss or nonvertebral fracture. Compared with higher levels of calcitriol, the risk of hip fracture was higher in men with the lowest 1,25(OH)2 D levels (8.70 to 51.60 pg/mL) after adjustment for baseline hip BMD (hazard ratio [HR] = 1.99, 95% confidence interval [CI] 1.19-3.33). Adjustment of 1,25(OH)2 D data for 25OHD (and vice versa) had little effect on the associations observed but did attenuate the hip fracture association of both vitamin D metabolites. In older men, higher 1,25(OH)2 D was associated with lower baseline BMD but was not related to the rate of bone loss or nonvertebral fracture risk. However, with BMD adjustment, a protective association for hip fracture was found with higher 1,25(OH)2 D. The associations of 25OHD with skeletal outcomes were generally stronger than those for 1,25(OH)2 D. These results do not support the hypothesis that measures of 1,25(OH)2 D improve the ability to predict adverse skeletal outcomes when 25OHD measures are available. © 2015 American Society for Bone and Mineral Research. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/25707402/Associations_of_25_Hydroxyvitamin_D_and_125_Dihydroxyvitamin_D_With_Bone_Mineral_Density_Bone_Mineral_Density_Change_and_Incident_Nonvertebral_Fracture_ L2 - https://doi.org/10.1002/jbmr.2487 DB - PRIME DP - Unbound Medicine ER -