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Title: Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D with Bone Mineral Density, Bone Mineral Density Change and Incident Non-Vertebral Fracture
Authors: Swanson, Christine M ×
Srikanth, Priya
Lee, Christine G
Cummings, Steven R
Jans, Ivo
Cauley, Jane A
Bouillon, Roger
Vanderschueren, Dirk
Orwoll, Eric S
Nielson, Carrie M
for the Osteoporotic Fractures in Men (MrOS) Study Research Group #
Issue Date: Aug-2015
Publisher: Blackwell Science, Inc.
Series Title: Journal of Bone and Mineral Research vol:30 issue:8 pages:1403-1413
Article number: 10.1002/jbmr.2487
Abstract: Relationships between 1,25(OH)2 D and skeletal outcomes are uncertain. We examined the associations of 1,25(OH)2 D with BMD, BMD change, and incident fractures in a cohort of older men and compared them to those of 25OHD. The study population included 1,000 men (age 74.6 ± 6.2 years) in the Osteoporotic Fractures in Men (MrOS) study, of which 537 men had longitudinal 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 non-vertebral 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 non-vertebral 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 non-vertebral fracture. Compared to higher levels of calcitriol, the risk of hip fracture was higher in men with the lowest 1,25(OH)2 D levels (8.70-51.60 pg/mL) after adjustment for baseline hip BMD (HR 1.99, 95% 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 non-vertebral fracture risk. However, with BMD adjustment, a protective association for hip fracture was seen 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. This article is protected by copyright. All rights reserved.
ISSN: 0884-0431
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Clinical and Experimental Endocrinology
× corresponding author
# (joint) last author

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