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Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study.
PLoS One. 2016; 11(10):e0164160.Plos

Abstract

Vitamin D deficiency and physical inactivity have been associated with bone loss and fractures, but their combined effect has scarcely been studied either in younger or older adults. Therefore, we aimed to assess the associations between physical activity, age and 25-hydroxyvitamin D (25(OH)D) status separately and in combination with the incidence of fracture risk in the EPIC-Norfolk cohort study. Baseline (1993-1998) self-reported physical activity and serum 25(OH)D concentrations at follow-up (1998-2000) were collected in 14,624 men and women (aged 42-82 y between 1998 and 2000). Fracture incidence was ascertained up to March 2015. Cox proportional hazard model was used to determine HRs of fractures by plasma 25(OH)D (<30, 30 to <50, 50 to <70, 70 to <90, >90 nmol/L), age (<65 y and >65 y) and physical activity (inactive and active) categories, by follow-up time per 20 nmol/L increase in serum 25(OH)D and to explore age-25(OH)D and physical activity-25(OH)D interactions. The age-, sex-, and month-adjusted HRs (95% CIs) for all fractures (1183 fractures) by increasing vitamin D category were not significantly different. With additional adjustment for body mass index, smoking status, alcohol intake, supplement use and history of fractures, the fracture risk was 29% lower in those participants with 50 to 70 nmol/L compared with those in the lowest quintile (<30 nmol/L). Physical inactivity based on a single baseline assessment was not associated with fracture risk. Vitamin D status appeared inversely related to fractures in middle aged adults. In older adults, the relationship between vitamin D status and fracture risk was observed to be J-shaped. Clinical and public health practice in vitamin D supplementation could partially explain these findings, although definitive conclusions are difficult due to potential changes in exposure status over the long follow up period.

Authors+Show Affiliations

Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Zaragoza, Spain. Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain.Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France.Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.Department of Public Health and Primary Care, Institute of Public Health, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Zaragoza, Spain. Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain.Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27749911

Citation

Julian, Cristina, et al. "Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results From the EPIC-Norfolk Cohort Study." PloS One, vol. 11, no. 10, 2016, pp. e0164160.
Julian C, Lentjes MA, Huybrechts I, et al. Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study. PLoS One. 2016;11(10):e0164160.
Julian, C., Lentjes, M. A., Huybrechts, I., Luben, R., Wareham, N., Moreno, L. A., & Khaw, K. T. (2016). Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study. PloS One, 11(10), e0164160. https://doi.org/10.1371/journal.pone.0164160
Julian C, et al. Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results From the EPIC-Norfolk Cohort Study. PLoS One. 2016;11(10):e0164160. PubMed PMID: 27749911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study. AU - Julian,Cristina, AU - Lentjes,Marleen A H, AU - Huybrechts,Inge, AU - Luben,Robert, AU - Wareham,Nick, AU - Moreno,Luis A, AU - Khaw,Kay-Tee, Y1 - 2016/10/17/ PY - 2016/07/22/received PY - 2016/09/20/accepted PY - 2016/10/18/pubmed PY - 2017/6/1/medline PY - 2016/10/18/entrez SP - e0164160 EP - e0164160 JF - PloS one JO - PLoS One VL - 11 IS - 10 N2 - Vitamin D deficiency and physical inactivity have been associated with bone loss and fractures, but their combined effect has scarcely been studied either in younger or older adults. Therefore, we aimed to assess the associations between physical activity, age and 25-hydroxyvitamin D (25(OH)D) status separately and in combination with the incidence of fracture risk in the EPIC-Norfolk cohort study. Baseline (1993-1998) self-reported physical activity and serum 25(OH)D concentrations at follow-up (1998-2000) were collected in 14,624 men and women (aged 42-82 y between 1998 and 2000). Fracture incidence was ascertained up to March 2015. Cox proportional hazard model was used to determine HRs of fractures by plasma 25(OH)D (<30, 30 to <50, 50 to <70, 70 to <90, >90 nmol/L), age (<65 y and >65 y) and physical activity (inactive and active) categories, by follow-up time per 20 nmol/L increase in serum 25(OH)D and to explore age-25(OH)D and physical activity-25(OH)D interactions. The age-, sex-, and month-adjusted HRs (95% CIs) for all fractures (1183 fractures) by increasing vitamin D category were not significantly different. With additional adjustment for body mass index, smoking status, alcohol intake, supplement use and history of fractures, the fracture risk was 29% lower in those participants with 50 to 70 nmol/L compared with those in the lowest quintile (<30 nmol/L). Physical inactivity based on a single baseline assessment was not associated with fracture risk. Vitamin D status appeared inversely related to fractures in middle aged adults. In older adults, the relationship between vitamin D status and fracture risk was observed to be J-shaped. Clinical and public health practice in vitamin D supplementation could partially explain these findings, although definitive conclusions are difficult due to potential changes in exposure status over the long follow up period. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27749911/Fracture_Risk_in_Relation_to_Serum_25_Hydroxyvitamin_D_and_Physical_Activity:_Results_from_the_EPIC_Norfolk_Cohort_Study_ L2 - https://dx.plos.org/10.1371/journal.pone.0164160 DB - PRIME DP - Unbound Medicine ER -