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Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis.
Osteoporos Int. 2017 04; 28(4):1377-1384.OI

Abstract

This study sought to determine the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health in postmenopausal women with low bone mass. A serum 25(OH)D concentration of 20 ng/mL rather than 30 ng/mL was appropriate for bone health.

INTRODUCTION

There is no consensus on the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health. The aim of this study was to investigate the relationship between 25(OH)D measured via liquid chromatography-mass spectrometry (LC-MS/MS), which is the current gold standard, and biochemical markers of bone turnover, PTH, and bone mineral densitometry (BMD).

METHODS

The medical records of 750 postmenopausal women newly diagnosed with osteoporosis or osteopenia at Samsung Medical Center from 2009 to 2014 were investigated. Subjects were divided into four groups according to serum 25(OH)D concentration: <10, 10-20, 20-30, and ≥30 ng/mL. Serum concentrations of bone-specific alkaline phosphatase (BS-ALP), carboxy-terminal cross-linking telopeptide of type 1 collagen (CTx), intact PTH (iPTH), and BMD were compared among the four groups using analysis of covariance. Thresholds of 25(OH)D were then assessed using spline plots and locally weighted regression smoothing (LOESS) plots.

RESULTS

25(OH)D was negatively correlated with serum BS-ALP, CTx, and iPTH. Only femur neck and total femur BMD had significant positive relationships with 25(OH)D. Cutoff values of 11.9 and 9.7 ng/mL were estimated from the spline plots of femur neck and total femur BMD, respectively. For iPTH, the LOESS plot showed a steep decrease to a serum 25(OH)D concentration of about 20 ng/mL, followed by a plateau.

CONCLUSIONS

According to this study, a serum 25(OH)D concentration of 20 ng/mL, rather than 30 ng/mL, was appropriate for bone health.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. ykmin@skku.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28188454

Citation

Lee, D Y., et al. "Serum 25-hydroxyvitamin D Cutoffs for Functional Bone Measures in Postmenopausal Osteoporosis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 28, no. 4, 2017, pp. 1377-1384.
Lee DY, Jee JH, Cho YY, et al. Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis. Osteoporos Int. 2017;28(4):1377-1384.
Lee, D. Y., Jee, J. H., Cho, Y. Y., Jang, J. Y., Yu, T. Y., Kim, T. H., Hong, Y. J., Hong, W. J., Jin, S. M., Hur, K. Y., Kim, J. H., Kim, S. W., Chung, J. H., Lee, M. K., & Min, Y. K. (2017). Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(4), 1377-1384. https://doi.org/10.1007/s00198-016-3892-0
Lee DY, et al. Serum 25-hydroxyvitamin D Cutoffs for Functional Bone Measures in Postmenopausal Osteoporosis. Osteoporos Int. 2017;28(4):1377-1384. PubMed PMID: 28188454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis. AU - Lee,D Y, AU - Jee,J H, AU - Cho,Y Y, AU - Jang,J Y, AU - Yu,T Y, AU - Kim,T H, AU - Hong,Y J, AU - Hong,W-J, AU - Jin,S-M, AU - Hur,K Y, AU - Kim,J H, AU - Kim,S W, AU - Chung,J H, AU - Lee,M K, AU - Min,Y-K, Y1 - 2017/02/10/ PY - 2016/08/17/received PY - 2016/12/18/accepted PY - 2017/2/12/pubmed PY - 2018/7/4/medline PY - 2017/2/12/entrez KW - 25-hydroxyvitamin D KW - Biochemical markers of bone turnover KW - Bone mineral density KW - Parathyroid hormone KW - Vitamin D insufficiency SP - 1377 EP - 1384 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 - 28 IS - 4 N2 - : This study sought to determine the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health in postmenopausal women with low bone mass. A serum 25(OH)D concentration of 20 ng/mL rather than 30 ng/mL was appropriate for bone health. INTRODUCTION: There is no consensus on the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health. The aim of this study was to investigate the relationship between 25(OH)D measured via liquid chromatography-mass spectrometry (LC-MS/MS), which is the current gold standard, and biochemical markers of bone turnover, PTH, and bone mineral densitometry (BMD). METHODS: The medical records of 750 postmenopausal women newly diagnosed with osteoporosis or osteopenia at Samsung Medical Center from 2009 to 2014 were investigated. Subjects were divided into four groups according to serum 25(OH)D concentration: <10, 10-20, 20-30, and ≥30 ng/mL. Serum concentrations of bone-specific alkaline phosphatase (BS-ALP), carboxy-terminal cross-linking telopeptide of type 1 collagen (CTx), intact PTH (iPTH), and BMD were compared among the four groups using analysis of covariance. Thresholds of 25(OH)D were then assessed using spline plots and locally weighted regression smoothing (LOESS) plots. RESULTS: 25(OH)D was negatively correlated with serum BS-ALP, CTx, and iPTH. Only femur neck and total femur BMD had significant positive relationships with 25(OH)D. Cutoff values of 11.9 and 9.7 ng/mL were estimated from the spline plots of femur neck and total femur BMD, respectively. For iPTH, the LOESS plot showed a steep decrease to a serum 25(OH)D concentration of about 20 ng/mL, followed by a plateau. CONCLUSIONS: According to this study, a serum 25(OH)D concentration of 20 ng/mL, rather than 30 ng/mL, was appropriate for bone health. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/28188454/Serum_25_hydroxyvitamin_D_cutoffs_for_functional_bone_measures_in_postmenopausal_osteoporosis_ L2 - https://dx.doi.org/10.1007/s00198-016-3892-0 DB - PRIME DP - Unbound Medicine ER -