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Association of 25-hydroxyvitamin D with areal and volumetric measures of bone mineral density and parathyroid hormone: impact of vitamin D-binding protein and its assays.
Osteoporos Int. 2016 Feb; 27(2):617-26.OI

Abstract

A comparison of the association of different forms of 25-hydroxyvitamin D [25(OH)D] with parathyroid hormone (PTH) and with areal and volumetric bone mineral density (BMD) demonstrated that bioavailable and free 25(OH)D do not provide a better index of vitamin D status in terms of bone health compared to total 25(OH)D.

INTRODUCTION

This study aims to compare measures of vitamin D-binding protein (DBP) using a monoclonal versus polyclonal ELISA and assess correlations of total versus estimated free and bioavailable 25(OH)D with BMD and PTH concentrations.

METHODS

DXA and peripheral quantitative CT (pQCT) scans were obtained in 304 adults (158 black, 146 white), ages 21-80 years. Free and bioavailable 25(OH)D were calculated from total 25(OH)D, DBP, and albumin concentrations. Multivariable linear regression with standardized beta coefficients was used to evaluate associations of bone measures and PTH with total, free, and bioavailable 25(OH)D.

RESULTS

Measures of DBP obtained using a monoclonal versus polyclonal ELISA were not correlated (r s = 0.02, p = 0.76). Free and bioavailable 25(OH)D based on the polyclonal assay were lower in black versus white participants (p < 0.0001); this race difference was not evident using the monoclonal assay. Adjusted for age, sex, calcium intake, and race, all forms of 25(OH)D were negatively associated with PTH, but the absolute coefficient was greatest for total 25(OH)D (-0.34, p < 0.001) versus free/bioavailable 25(OH)D (-0.18/-0.24 depending on DBP assay, p ≤ 0.003). In analyses stratified on race, none of the measures of 25(OH)D were associated with BMD across DXA and pQCT sites.

CONCLUSIONS

The monoclonal versus polyclonal ELISA yielded highly discrepant measures of DBP, particularly among black individuals, likely related to established race differences in DBP polymorphisms. Contrary to prior studies, our findings indicate that using DBP to estimate bioavailable and free 25(OH)D does not provide a better index of vitamin D status in terms of bone health.

Authors+Show Affiliations

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.Stanford University School of Medicine, Stanford, CA, USA.Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Philadelphia VA Medical Center, Philadelphia, PA, USA.The Children's Hospital of Philadelphia, Philadelphia, PA, USA.The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA.The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA.The Children's Hospital of Philadelphia, Philadelphia, PA, USA.The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA. denburgm@email.chop.edu.

Pub Type(s)

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

Language

eng

PubMed ID

26359185

Citation

Jemielita, T O., et al. "Association of 25-hydroxyvitamin D With Areal and Volumetric Measures of Bone Mineral Density and Parathyroid Hormone: Impact of Vitamin D-binding Protein and Its Assays." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 27, no. 2, 2016, pp. 617-26.
Jemielita TO, Leonard MB, Baker J, et al. Association of 25-hydroxyvitamin D with areal and volumetric measures of bone mineral density and parathyroid hormone: impact of vitamin D-binding protein and its assays. Osteoporos Int. 2016;27(2):617-26.
Jemielita, T. O., Leonard, M. B., Baker, J., Sayed, S., Zemel, B. S., Shults, J., Herskovitz, R., & Denburg, M. R. (2016). Association of 25-hydroxyvitamin D with areal and volumetric measures of bone mineral density and parathyroid hormone: impact of vitamin D-binding protein and its assays. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(2), 617-26. https://doi.org/10.1007/s00198-015-3296-6
Jemielita TO, et al. Association of 25-hydroxyvitamin D With Areal and Volumetric Measures of Bone Mineral Density and Parathyroid Hormone: Impact of Vitamin D-binding Protein and Its Assays. Osteoporos Int. 2016;27(2):617-26. PubMed PMID: 26359185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of 25-hydroxyvitamin D with areal and volumetric measures of bone mineral density and parathyroid hormone: impact of vitamin D-binding protein and its assays. AU - Jemielita,T O, AU - Leonard,M B, AU - Baker,J, AU - Sayed,S, AU - Zemel,B S, AU - Shults,J, AU - Herskovitz,R, AU - Denburg,M R, Y1 - 2015/09/10/ PY - 2015/07/02/received PY - 2015/08/14/accepted PY - 2015/9/12/entrez PY - 2015/9/12/pubmed PY - 2016/12/15/medline KW - Bone mineral density KW - Parathyroid hormone KW - Vitamin D KW - Vitamin D-binding protein SP - 617 EP - 26 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 27 IS - 2 N2 - UNLABELLED: A comparison of the association of different forms of 25-hydroxyvitamin D [25(OH)D] with parathyroid hormone (PTH) and with areal and volumetric bone mineral density (BMD) demonstrated that bioavailable and free 25(OH)D do not provide a better index of vitamin D status in terms of bone health compared to total 25(OH)D. INTRODUCTION: This study aims to compare measures of vitamin D-binding protein (DBP) using a monoclonal versus polyclonal ELISA and assess correlations of total versus estimated free and bioavailable 25(OH)D with BMD and PTH concentrations. METHODS: DXA and peripheral quantitative CT (pQCT) scans were obtained in 304 adults (158 black, 146 white), ages 21-80 years. Free and bioavailable 25(OH)D were calculated from total 25(OH)D, DBP, and albumin concentrations. Multivariable linear regression with standardized beta coefficients was used to evaluate associations of bone measures and PTH with total, free, and bioavailable 25(OH)D. RESULTS: Measures of DBP obtained using a monoclonal versus polyclonal ELISA were not correlated (r s = 0.02, p = 0.76). Free and bioavailable 25(OH)D based on the polyclonal assay were lower in black versus white participants (p < 0.0001); this race difference was not evident using the monoclonal assay. Adjusted for age, sex, calcium intake, and race, all forms of 25(OH)D were negatively associated with PTH, but the absolute coefficient was greatest for total 25(OH)D (-0.34, p < 0.001) versus free/bioavailable 25(OH)D (-0.18/-0.24 depending on DBP assay, p ≤ 0.003). In analyses stratified on race, none of the measures of 25(OH)D were associated with BMD across DXA and pQCT sites. CONCLUSIONS: The monoclonal versus polyclonal ELISA yielded highly discrepant measures of DBP, particularly among black individuals, likely related to established race differences in DBP polymorphisms. Contrary to prior studies, our findings indicate that using DBP to estimate bioavailable and free 25(OH)D does not provide a better index of vitamin D status in terms of bone health. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26359185/Association_of_25_hydroxyvitamin_D_with_areal_and_volumetric_measures_of_bone_mineral_density_and_parathyroid_hormone:_impact_of_vitamin_D_binding_protein_and_its_assays_ L2 - https://doi.org/10.1007/s00198-015-3296-6 DB - PRIME DP - Unbound Medicine ER -