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Effect of serum 25-hydroxyvitamin D concentrations on skeletal mineralization in black and white women

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

There is controversy over the adverse effect of vitamin D deficiency on bone mineralization. The purpose of this study was to determine the ethnical differences in vitamin D and bone mineralization as well as the association between vitamin D deficiency and bone mineralization defects.

Materials and Methods

We examined serum 25-hydroxyvitamin D (25(OH)D) levels and transiliac bone biopsies in 92 healthy black and white women, aged 20–73 years. The major bone mineralization indices include osteoid volume per bone volume (OV/BV), osteoid surfaces per bone surface (OS/BS), osteoid thickness (O.Th) and mineralization lag time (Mlt).

Results

25(OH)D levels were significantly lower and prevalence of 25(OH)D deficiency was significantly higher in blacks than in whites. However, none of the mineralization indices showed significant difference between the two groups. In addition, there was no significant correlation between 25(OH)D levels and mineralization indices in both black and white cohorts. Only one case had O.Th marginally greater than 12.5 µm, which is the cutoff value for identifying bone mineralization defects. OV/BV and OS/BS, but not O.Th, were significantly positively correlated with activation frequency (Ac.f).

Conclusions

Our study indicated: (1) vitamin D deficiency is common, but bone mineralization is not impaired in black women, and (2) there are no significant correlations between serum 25(OH)D levels and bone mineralization indices, suggesting that vitamin D deficiency may not be an independent factor contributing to bone mineralization defects and osteomalacia.

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References

  1. Holick MF (2017) The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 18:153–165. https://doi.org/10.1007/s11154-017-9424-1 (PubMed PMID: 28516265)

    Article  CAS  PubMed  Google Scholar 

  2. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281 (PubMed PMID: 17634462)

    Article  CAS  Google Scholar 

  3. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716. https://doi.org/10.1007/s00198-005-1867-7 (Epub 2005/03/19; PubMed PMID: 15776217)

    Article  CAS  PubMed  Google Scholar 

  4. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930. https://doi.org/10.1210/jc.2011-0385

    Article  CAS  PubMed  Google Scholar 

  5. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K et al (2016) Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab 101:394–415. https://doi.org/10.1210/jc.2015-2175 (PubMed PMID: 26745253; PubMed Central PMCID: PMCPMC4880117)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Giustina A, Adler RA, Binkley N, Bouillon R, Ebeling PR, Lazaretti-Castro M et al (2019) Controversies in vitamin D: summary statement from an international conference. J Clin Endocrinol Metab 104:234–240. https://doi.org/10.1210/jc.2018-01414 (PubMed PMID: 30383226)

    Article  PubMed  Google Scholar 

  7. Lee DY, Jee JH, Cho YY, Jang JY, Yu TY, Kim TH et al (2017) Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis. Osteoporos Int 28:1377–1384. https://doi.org/10.1007/s00198-016-3892-0 (Epub 2017/02/12; PubMed PMID: 28188454)

    Article  CAS  PubMed  Google Scholar 

  8. Ferrone F, Pepe J, Danese VC, Fassino V, Cecchetti V, De Lucia F et al (2019) The relative influence of serum ionized calcium and 25-hydroxyvitamin D in regulating PTH secretion in healthy subjects. Bone 125:200–206. https://doi.org/10.1016/j.bone.2019.05.029 (Epub 2019/05/28; PubMed PMID: 31129357)

    Article  CAS  PubMed  Google Scholar 

  9. Olmos JM, Hernandez JL, Garcia-Velasco P, Martinez J, Llorca J, Gonzalez-Macias J (2016) Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults. Osteoporos Int 27:105–113. https://doi.org/10.1007/s00198-015-3219-6 (Epub 2015/07/03; PubMed PMID: 26134682)

    Article  CAS  PubMed  Google Scholar 

  10. Shah S, Chiang C, Sikaris K, Lu Z, Bui M, Zebaze R et al (2017) Serum 25-hydroxyvitamin D insufficiency in search of a bone disease. J Clin Endocrinol Metab 102:2321–2328. https://doi.org/10.1210/jc.2016-3189 (PubMed PMID: 28379394)

    Article  PubMed  Google Scholar 

  11. Gao C, Qiao J, Li SS, Yu WJ, He JW, Fu WZ et al (2017) The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China. Osteoporos Int 28:211–218. https://doi.org/10.1007/s00198-016-3692-6 (Epub 2016/07/30; PubMed PMID: 27468899)

    Article  CAS  PubMed  Google Scholar 

  12. DeLuca HF (2004) Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 80:1689S-S1696. https://doi.org/10.1093/ajcn/80.6.1689S (PubMed PMID: 15585789)

    Article  CAS  PubMed  Google Scholar 

  13. Rosen CJ (2011) Clinical practice. Vitamin D insufficiency. N Engl J Med 364:248–54. https://doi.org/10.1056/NEJMcp1009570 (Epub 2011/01/21; PubMed PMID: 21247315)

    Article  CAS  PubMed  Google Scholar 

  14. Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S et al (2010) Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res 25:305–12. https://doi.org/10.1359/jbmr.090728 (Epub 2009/07/15; PubMed PMID: 19594303)

    Article  CAS  PubMed  Google Scholar 

  15. Han ZH, Palnitkar S, Rao DS, Nelson D, Parfitt AM (1996) Effect of ethnicity and age or menopause on the structure and geometry of iliac bone. J Bone Miner Res 11:1967–1975 (PubMed PMID: 8970900)

    Article  CAS  Google Scholar 

  16. Han ZH, Palnitkar S, Rao DS, Nelson D, Parfitt AM (1997) Effects of ethnicity and age or menopause on the remodeling and turnover of iliac bone: implications for mechanisms of bone loss. J Bone Miner Res 12:498–508 (PubMed PMID: 9101361)

    Article  CAS  Google Scholar 

  17. Parfitt AM, Han ZH, Palnitkar S, Rao DS, Shih MS, Nelson D (1997) Effects of ethnicity and age or menopause on osteoblast function, bone mineralization, and osteoid accumulation in iliac bone. J Bone Miner Res 12:1864–1873 (PubMed PMID: 9383691)

    Article  CAS  Google Scholar 

  18. Kleerekoper M, Nelson DA, Peterson EL, Flynn MJ, Pawluszka AS, Jacobsen G et al (1994) Reference data for bone mass, calciotropic hormones, and biochemical markers of bone remodeling in older (55–75) postmenopausal white and black women. J Bone Miner Res 9:1267–1276 (PubMed PMID: 7976509)

    Article  CAS  Google Scholar 

  19. Rao DS, Parikh N, Palnitkar S, Qiu S (2013) The effect of endogenous parathyroid hormone in iliac bone structure and turnover in healthy postmenopausal women. Calcif Tissue Int 93:288–95. https://doi.org/10.1007/s00223-013-9756-0 (Epub 2013/07/12; PubMed PMID: 23842963)

    Article  CAS  PubMed  Google Scholar 

  20. Rao DS (1983) Practical approach to bone biopsy. In: Recker R (ed) Bone histomorphometry: techniques and interpretations. CRC Press, Boca Raton, pp 3–11

    Google Scholar 

  21. Dempster DW, Compston JE, Drezner MK, Glorieux FH, Kanis JA, Malluche H et al (2013) Standardized nomenclature, symbols, and units for bone histomorphometry: a 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 28:2–17. https://doi.org/10.1002/jbmr.1805 (Epub 2012/12/01; PubMed PMID: 23197339)

    Article  PubMed  Google Scholar 

  22. Alzaman NS, Dawson-Hughes B, Nelson J, D’Alessio D, Pittas AG (2016) Vitamin D status of black and white Americans and changes in vitamin D metabolites after varied doses of vitamin D supplementation. Am J Clin Nutr 104:205–214. https://doi.org/10.3945/ajcn.115.129478 (PubMed PMID: 27194308; PubMed Central PMCID: PMCPMC4919528)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Aloia J, Mikhail M, Dhaliwal R, Shieh A, Usera G, Stolberg A et al (2015) Free 25(OH)D and the vitamin D paradox in African Americans. J Clin Endocrinol Metab 100:3356–3363. https://doi.org/10.1210/JC.2015-2066 (PubMed PMID: 26161453; PubMed Central PMCID: PMCPMC4570168)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Forrest KY, Stuhldreher WL (2011) Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res 31:48–54. https://doi.org/10.1016/j.nutres.2010.12.001 (PubMed PMID: 21310306)

    Article  CAS  PubMed  Google Scholar 

  25. Gutierrez OM, Farwell WR, Kermah D, Taylor EN (2011) Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int 22:1745–1753. https://doi.org/10.1007/s00198-010-1383-2 (PubMed PMID: 20848081; PubMed Central PMCID: PMCPMC3093445)

    Article  CAS  PubMed  Google Scholar 

  26. Harris SS (2006) Vitamin D and African Americans. J Nutr 136:1126–1129. https://doi.org/10.1093/jn/136.4.1126 (PubMed PMID: 16549493)

    Article  CAS  PubMed  Google Scholar 

  27. Aloia JF (2008) African Americans, 25-hydroxyvitamin D, and osteoporosis: a paradox. Am J Clin Nutr 88:545S-S550. https://doi.org/10.1093/ajcn/88.2.545S (PubMed PMID: 18689399; PubMed Central PMCID: PMCPMC2777641)

    Article  CAS  PubMed  Google Scholar 

  28. Brown LL, Cohen B, Tabor D, Zappala G, Maruvada P, Coates PM (2018) The vitamin D paradox in Black Americans: a systems-based approach to investigating clinical practice, research, and public health—expert panel meeting report. BMC Proc 12:6. https://doi.org/10.1186/s12919-018-0102-4 (PubMed PMID: 30044889; PubMed Central PMCID: PMCPMC5954269)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Weaver CM, McCabe LD, McCabe GP, Braun M, Martin BR, Dimeglio LA et al (2008) Vitamin D status and calcium metabolism in adolescent black and white girls on a range of controlled calcium intakes. J Clin Endocrinol Metab 93:3907–3914. https://doi.org/10.1210/jc.2008-0645 (PubMed PMID: 18682505; PubMed Central PMCID: PMCPMC2579645)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Cosman F, Morgan DC, Nieves JW, Shen V, Luckey MM, Dempster DW et al (1997) Resistance to bone resorbing effects of PTH in black women. J Bone Miner Res 12:958–966. https://doi.org/10.1359/jbmr.1997.12.6.958 (PubMed PMID: 9169356)

    Article  CAS  PubMed  Google Scholar 

  31. Cosman F, Nieves J, Dempster D, Lindsay R (2007) Vitamin D economy in blacks. J Bone Miner Res 22:V34–V38. https://doi.org/10.1359/jbmr.07s220 (PubMed PMID: 18290719)

    Article  CAS  PubMed  Google Scholar 

  32. Cauley JA, Lui LY, Ensrud KE, Zmuda JM, Stone KL, Hochberg MC et al (2005) Bone mineral density and the risk of incident nonspinal fractures in black and white women. JAMA 293:2102–2108 (PubMed PMID: 15870413)

    Article  CAS  Google Scholar 

  33. Sahota O, Mundey MK, San P, Godber IM, Lawson N, Hosking DJ (2004) The relationship between vitamin D and parathyroid hormone: calcium homeostasis, bone turnover, and bone mineral density in postmenopausal women with established osteoporosis. Bone 35:312–319 (PubMed PMID: 15207772)

    Article  CAS  Google Scholar 

  34. Seitz S, Koehne T, Ries C, De Novo OA, Barvencik F, Busse B et al (2013) Impaired bone mineralization accompanied by low vitamin D and secondary hyperparathyroidism in patients with femoral neck fracture. Osteoporos Int 24:641–9. https://doi.org/10.1007/s00198-012-2011-0 (Epub 2012/05/15; PubMed PMID: 22581296)

    Article  CAS  PubMed  Google Scholar 

  35. Gallagher JC, Jindal PS, Smith LM (2014) Vitamin D supplementation in young White and African American women. J Bone Miner Res 29:173–181. https://doi.org/10.1002/jbmr.2010 (PubMed PMID: 23761326)

    Article  CAS  PubMed  Google Scholar 

  36. Gallagher JC, Sai A, Templin T 2nd, Smith L (2012) Dose response to vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437. https://doi.org/10.7326/0003-4819-156-6-201203200-00005 (PubMed PMID: 22431675)

    Article  PubMed  Google Scholar 

  37. Newberry SJ, Chung M, Shekelle PG, Booth MS, Liu JL, Maher AR et al (2014) Vitamin D and calcium: a systematic review of health outcomes (update). Evid Rep Technol Assess (Full Rep) 217:1–929. https://doi.org/10.23970/AHRQEPCERTA217 (PubMed PMID: 30313003)

    Article  Google Scholar 

  38. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501 (PubMed PMID: 11493580)

    Article  CAS  Google Scholar 

  39. Hosking DJ, Campbell GA, Kemm JR, Cotton RE, Knight ME, Berryman R et al (1983) Screening for subclinical osteomalacia in the elderly: normal ranges or pragmatism? Lancet 2:1290–1292. https://doi.org/10.1016/s0140-6736(83)91160-1 (PubMed PMID: 6139628)

    Article  CAS  PubMed  Google Scholar 

  40. Compston JE, Vedi S, Croucher PI (1991) Low prevalence of osteomalacia in elderly patients with hip fracture. Age Ageing 20:132–134. https://doi.org/10.1093/ageing/20.2.132 (PubMed PMID: 2053503)

    Article  CAS  PubMed  Google Scholar 

  41. Wilton TJ, Hosking DJ, Pawley E, Stevens A, Harvey L (1987) Osteomalacia and femoral neck fractures in the elderly patient. J Bone Jt Surg Br 69:388–390 (PubMed PMID: 3584190)

    Article  CAS  Google Scholar 

  42. Kemm JR, Campbell G, Cotton RE, Hosking DJ, Boyd RV (1984) Osteoid in bones of elderly patients without bone disease. Age Ageing 13:140–151. https://doi.org/10.1093/ageing/13.3.144 (PubMed PMID: 6731171)

    Article  CAS  PubMed  Google Scholar 

  43. Hoikka V, Alhava EM, Savolainen K, Parviainen M (1982) Osteomalacia in fractures of the proximal femur. Acta Orthop Scand 53:255–260 (PubMed PMID: 7136573)

    Article  CAS  Google Scholar 

  44. Campbell GA, Kemm JR, Hosking DJ, Boyd RV (1984) How common is osteomalacia in the elderly? Lancet 2:386–388. https://doi.org/10.1016/s0140-6736(84)90553-1 (PubMed PMID: 6147464)

    Article  CAS  PubMed  Google Scholar 

  45. Bhan A, Qiu S, Rao SD (2018) Bone histomorphometry in the evaluation of osteomalacia. Bone Rep 8:125–34. https://doi.org/10.1016/j.bonr.2018.03.005 (Epub 2018/06/30; PubMed PMID: 29955631; PubMed Central PMCID: PMCPMC6020114)

    Article  PubMed  PubMed Central  Google Scholar 

  46. Melsen F, Mosekilde L (1980) Trabecular bone mineralization lag time determined by tetracycline double-labeling in normal and certain pathological conditions. Acta Pathol Microbiol Scand A 88:83–88 (PubMed PMID: 7368937)

    CAS  PubMed  Google Scholar 

  47. Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ et al (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 2:595–610 (PubMed PMID: 3455637)

    Article  CAS  Google Scholar 

  48. Parfitt AM, Qiu S, Rao DS (2004) The mineralization index—a new approach to the histomorphometric appraisal of osteomalacia. Bone 35:320–325 (PubMed PMID: 15207773)

    Article  CAS  Google Scholar 

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Acknowledgements

The work was partly supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under Award Number AR062103.

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Authors and Affiliations

  1. Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, 48202, USA

    Shijing Qiu & Sudhaker D. Rao

  2. Division of Endocrinology, Diabetes, and Bone and Mineral Disorders, Henry Ford Hospital, Detroit, MI, USA

    Sudhaker D. Rao

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  1. Shijing Qiu
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Contributions

Conceptualization: SQ and SR. Data curation: SQ. Formal analysis: SQ. Methodology: SQ and SR. Project administration: SQ. Funding acquisition: SR. Writing—original draft: SQ. Writing—review and editing: SQ and SR. Revision—SQ and SR.

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Correspondence to Shijing Qiu.

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Qiu, S., Rao, S.D. Effect of serum 25-hydroxyvitamin D concentrations on skeletal mineralization in black and white women. J Bone Miner Metab 39, 843–850 (2021). https://doi.org/10.1007/s00774-021-01237-y

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