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Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause.
J Clin Endocrinol Metab. 2015 May; 100(5):2046-54.JC

Abstract

CONTEXT

Low levels of serum 25 Hydroxyvitamin D [25(OH)D] have been linked to greater fracture risk in older women.

OBJECTIVE

This study aimed to determine whether higher 25(OH)D is associated with slower loss of bone mineral density (BMD) and lower fracture risk during the menopausal transition.

DESIGN, SETTING, AND PARTICIPANTS

This was a prospective cohort study at five clinical centers in the United States. Mean age was 48.5 ± 2.7 years. The fracture analysis included 124 women with an incident traumatic fracture, 88 with incident nontraumatic fracture, and 1532 women without incident fractures; average followup was 9.5 years. BMD analysis included 922 women with a documented final menstrual period.

MAIN OUTCOME MEASURES

Serum 25(OH)D was measured by liquid chromatography tandem mass spectrometry at the third annual clinic visit. BMD was measured and incident fractures ascertained at each annual visit.

RESULTS

The mean 25(OH)D was 21.8 ng/mL; seven-hundred two (43%) of the women had 25(OH)D values <20 ng/mL. There was no significant association between 25(OH)D and traumatic fractures. In multivariate adjusted hazards models, the hazard ratio (HR) for nontraumatic fractures (95% confidence interval [CI]) was 0.72 (0.54-0.96) for each 10-ng/mL increase in 25(OH)D. Comparing women whose 25(OH)D was ≥20 vs <20 ng/mL, the HR (95% CI) for fracture was 0.54 (0.32-0.89). Changes in lumbar spine and femoral neck bone mineral density across menopause were not significantly associated with serum 25(OH)D level.

CONCLUSION

Serum 25(OH)D levels are inversely associated with nontraumatic fracture in mid-life women. Vitamin D supplementation is warranted in midlife women with 25(OH)D levels <20 ng/mL.

Authors+Show Affiliations

Graduate School of Public Health, Department of Epidemiology (J.A.C., K.R., Y.L.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Division of Geriatrics (G.A.G.), David Geffen School of Medicine at UCLA, Los Angeles, California 90095; Division of Reproductive Endocrinology and Infertility (J.F.R.), University of Michigan Medical School, Ann Arbor, Michigan 48109; Division of Research (J.C.L.), Kaiser Permanente Northern California, Oakland, California 94612; and Department of Medicine (S.-A.B.-B., J.S.F.), Endocrine Unit, MA General Hospital, Boston, Massachusetts 02114.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25719933

Citation

Cauley, Jane A., et al. "Serum 25 Hydroxyvitamin D, Bone Mineral Density and Fracture Risk Across the Menopause." The Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 5, 2015, pp. 2046-54.
Cauley JA, Greendale GA, Ruppert K, et al. Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause. J Clin Endocrinol Metab. 2015;100(5):2046-54.
Cauley, J. A., Greendale, G. A., Ruppert, K., Lian, Y., Randolph, J. F., Lo, J. C., Burnett-Bowie, S. A., & Finkelstein, J. S. (2015). Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause. The Journal of Clinical Endocrinology and Metabolism, 100(5), 2046-54. https://doi.org/10.1210/jc.2014-4367
Cauley JA, et al. Serum 25 Hydroxyvitamin D, Bone Mineral Density and Fracture Risk Across the Menopause. J Clin Endocrinol Metab. 2015;100(5):2046-54. PubMed PMID: 25719933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause. AU - Cauley,Jane A, AU - Greendale,Gail A, AU - Ruppert,Kristine, AU - Lian,Yinjuan, AU - Randolph,John F,Jr AU - Lo,Joan C, AU - Burnett-Bowie,Sherri-Ann, AU - Finkelstein,Joel S, Y1 - 2015/02/26/ PY - 2015/2/27/entrez PY - 2015/2/27/pubmed PY - 2015/10/1/medline SP - 2046 EP - 54 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 100 IS - 5 N2 - CONTEXT: Low levels of serum 25 Hydroxyvitamin D [25(OH)D] have been linked to greater fracture risk in older women. OBJECTIVE: This study aimed to determine whether higher 25(OH)D is associated with slower loss of bone mineral density (BMD) and lower fracture risk during the menopausal transition. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective cohort study at five clinical centers in the United States. Mean age was 48.5 ± 2.7 years. The fracture analysis included 124 women with an incident traumatic fracture, 88 with incident nontraumatic fracture, and 1532 women without incident fractures; average followup was 9.5 years. BMD analysis included 922 women with a documented final menstrual period. MAIN OUTCOME MEASURES: Serum 25(OH)D was measured by liquid chromatography tandem mass spectrometry at the third annual clinic visit. BMD was measured and incident fractures ascertained at each annual visit. RESULTS: The mean 25(OH)D was 21.8 ng/mL; seven-hundred two (43%) of the women had 25(OH)D values <20 ng/mL. There was no significant association between 25(OH)D and traumatic fractures. In multivariate adjusted hazards models, the hazard ratio (HR) for nontraumatic fractures (95% confidence interval [CI]) was 0.72 (0.54-0.96) for each 10-ng/mL increase in 25(OH)D. Comparing women whose 25(OH)D was ≥20 vs <20 ng/mL, the HR (95% CI) for fracture was 0.54 (0.32-0.89). Changes in lumbar spine and femoral neck bone mineral density across menopause were not significantly associated with serum 25(OH)D level. CONCLUSION: Serum 25(OH)D levels are inversely associated with nontraumatic fracture in mid-life women. Vitamin D supplementation is warranted in midlife women with 25(OH)D levels <20 ng/mL. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/25719933/Serum_25_hydroxyvitamin_D_bone_mineral_density_and_fracture_risk_across_the_menopause_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-4367 DB - PRIME DP - Unbound Medicine ER -