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Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study

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Abstract

Summary

Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. We conducted a 6-year cohort study of 773 community-dwelling elderly Japanese women and found that serum 25-hydroxyvitamin D (25(OH)D) ≥ 71 nmol/L was associated with a reduced risk of osteoporotic limb and vertebral fractures.

Introduction

Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. This study aimed to clarify the association between vitamin D and other markers of nutritional status with the incidence of fracture in elderly Japanese women.

Methods

We conducted a cohort study with a 6-year follow-up of 773 community-dwelling women aged 69 years and older. The 6-year follow-up ended in 2009. We assessed serum 25-hydroxyvitamin D, undercarboxylated osteocalcin (an index of vitamin K status), and calcium intake. The primary outcome was incident limb and vertebral fractures. Covariates were forearm bone mineral density (BMD), age, body mass index, osteoporosis treatment, and physical activity.

Results

The mean serum 25(OH)D concentration was 60.0 nmol/L. Thirty-seven limb fractures and 14 vertebral fractures occurred in 4,392 person-years. Lower forearm BMD was significantly associated with increased incident fracture (P = 0.0242). The adjusted hazard ratios (HR) of fracture for the first quartile (<47.7 nmol/L) and the third quartile (59.2–70.9 nmol/L) of serum 25(OH)D, compared to the fourth quartile (≥71.0 nmol/L), were 2.82 (95% confidence interval (CI), 1.09–7.34) and 2.82 (95%CI, 1.09–7.27), respectively. The pooled adjusted HR was 0.42 (95%CI, 0.18–0.99) when the incidence in the fourth quartile (≥71.0 nmol/L) was compared to the other three quartiles combined (<71.0 nmol/L). Vitamin K status and calcium intake were not associated with incident fracture.

Conclusions

Sufficient vitamin D status, i.e., serum 25(OH)D ≥ 71 nmol/L, is associated with low limb and vertebral fracture risk in community-dwelling elderly women.

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Acknowledgements

We wish to thank the staff of Muramatsu Health Center for their help in data collection. We are also indebted to Kyowa Medex Co., Ltd. and Eisai Co., Ltd. for assays of serum 25(OH)D and serum ucOC, respectively, and to Toyo Medic Inc. for their assistance in making the BMD measurements. This study was supported in part by a grant from the Nakatomi Foundation for scientific research relating to health promotion focusing on physical exercise, a grant from the Japan Rheumatism Foundation, a grant from the Japan Dairy Association, the Japan Osteoporosis Society encouragement award (2003), a grant from the Foundation for Total Health Promotion, and a Grant-in-Aid for Scientific Research (C) No.40339958 from the Japanese Ministry of Education, Culture, Sports, Science, and Technology. We also thank the following institutions for providing us with relevant medical information: Igarashi Orthopedic Clinic, Ishizone Clinic, Ito Clinic, Kaneko Clinic, Kasahara Clinic, Koyama Orthopedic Clinic, Nanbugo General Hospital, Nanbugo Kosei Hospital, Murata Clinic, Takeda Clinic, Yamamura Orthopedic Clinic in Gosen City, Kaetsu Hospital, Kameda-Daiichi Hospital, Nekoyama Miyao Hospital in Niigata City, and Tominaga Kusano Hospital in Sanjo City.

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Authors and Affiliations

  1. Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    K. Nakamura, M. Oyama & Y. Tsuchiya

  2. Department of Health and Nutrition, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 951-3198, Japan

    T. Saito

  3. Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 951-3198, Japan

    R. Oshiki & R. Kobayashi

  4. Department of Nursing, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 951-3198, Japan

    T. Nishiwaki & M. Nashimoto

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  1. K. Nakamura
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  2. T. Saito
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Correspondence to K. Nakamura.

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Nakamura, K., Saito, T., Oyama, M. et al. Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int 22, 97–103 (2011). https://doi.org/10.1007/s00198-010-1213-6

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  • DOI: https://doi.org/10.1007/s00198-010-1213-6

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