Abstract
OBJECTIVE
We aimed to determine the prevalence of 25(OH)D (D2 and D3 independently) inadequacy in healthy young/middle-aged men and to investigate its relationship with BMD, bone markers, demographic and lifestyle parameters such as age, BMI, smoking, alcohol consumption and dietary calcium intake.
DESIGN
We determined 25(OH)D levels using LC-MS/MS, a robust method for measurement of both 25(OH)D3 and 25(OH)D2, iPTH, osteocalcin, beta C terminal cross-linked telopeptides of type I collagen (b-CTXs), procollagen type 1 amino-terminal propeptide (PINP), BMD at L2-L4 and proximal femur, smoking habits, daily dietary calcium intake and alcohol consumption in 181 randomly selected healthy men aged 20–50y.
RESULTS
The prevalence of vitamin D deficiency (25(OH)D <20ng/ml) was 50.3%. Only 8.8% of the participants had vitamin D sufficiency (25(OH)D ≥30ng/ml). We found a strong correlation between 25(OH)D and smoking in the totality of participants (p<0.001). 25(OH)D level was lower by approximately 4.3 ng/dl (p<0.001) in a smoker compared to a non-smoker among the totality of participants, while this value increased to 9.2ng/ml in the 40–50y subgroup (p=0.003). A multinomial logistic regression model demonstrated that a young smoker (20–29y) had 58% increased likelihood of having vitamin D deficiency compared to a non-smoker of the same age group (p=0.041).
CONCLUSIONS
A high prevalence of vitamin D deficiency was identified in a young and middle-aged male population. Smoking is a significant determinant of serum 25(OH)D, while it increases significantly the likelihood of having vitamin D deficiency. In our hands, vitamin D levels are not a determinant of bone turnover and BMD in this population.
Article PDF
Similar content being viewed by others
References
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.
Adami S, Bertoldo F, Braga V, et al, 2009 25-hydroxy vitamin D levels in healthy premenopausal women: association with bone turnover markers and bone mineral density. Bone 45: 423–426.
Ooms ME, Lips P, Roos JC, et al, 1995 Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res 10: 1177–1184.
Bhattoa HP, Nagy E, More C, et al, 2013 Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in healthy Hungarian men over 50 years of age: the HunMen Study. Osteoporos Int 24: 179–186.
Bhattoa HP, Bettembuk P, Ganacharya S, Balogh A, 2004 Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. Osteoporos Int 15: 447–451.
Saquib N, von Muhlen D, Garland CF, Barrett-Connor E, 2006 Serum 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density in men: the Rancho Bernardo study. Osteoporos Int 17: 1734–1741.
Szulc P, Munoz F, Marchand F, Chapuy MC, Delmas PD, 2003 Role of vitamin D and parathyroid hormone in the regulation of bone turnover and bone mass in men: the MINOS study. Calcif Tissue Int 73: 520–530.
Holick MF, 2007 Vitamin D deficiency. N Engl J Med 357: 266–281.
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al, 2011 Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96: 1911–1930.
Williams DM, Fraser A, Sayers A, et al, 2012 Associations of 25-hydroxyvitamin D2 and D3 with cardiovascular risk factors in childhood: cross-sectional findings from the Avon Longitudinal Study of Parents and Children. J Clin Endocrinol Metab 97: 1563–1571.
Shah I, Petroczi A, Tabet N, Klugman A, Isaac M, Naughton DP, 2012 Low 250H vitamin D2 levels found in untreated Alzheimer’s patients, compared to acetylcholinesterase-inhibitor treated and controls. Curr Alzheimer Res 9: 1069–1076.
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al, 2012 Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 97: 1153–1158.
Lips P, Hosking D, Lippuner K, et al, 2006 The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med 260: 245–254.
Choi HS, Oh HJ, Choi H, et al, 2011 Vitamin D insufficiency in Korea—a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 96: 643–651.
Hekimsoy Z, Dinc G, Kafesciler S, et al, Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health 10: 782.
Hojskov CS, Heickendorff L, Moller HJ, 2010 High-throughput liquid-liquid extraction and LCMSMS assay for determination of circulating 25(OH) vitamin D3 and D2 in the routine clinical laboratory. Clin Chim Acta 411: 114–116.
Bogusz MJ, Al Enazi E, Tahtamoni M, Jawaad JA, Al Tufail M, 2011 Determination of serum vitamins 25-OH-D2 and 25-OH-D3 with liquid chromatography-tandem mass spectrometry using atmospheric pressure chemical ionization or electrospray source and core-shell or sub-2 mum particle columns: a comparative study. Clin Biochem 44: 1329–1337.
Chen H, McCoy LF, Schleicher RL, Pfeiffer CM, 2008 Measurement of 25-hydroxyvitamin D3 (25OHD3) and 25-hydroxyvitamin D2 (25OHD2) in human serum using liquid chromatography-tandem mass spectrometry and its comparison to a radioimmunoassay method. Clin Chim Acta 391: 6–12.
Aboraia AS, Makowski B, Bahja A, et al, 2010 Synthesis and CYP24A1 inhibitory activity of (E)-2-(2-substituted benzylidene)- and 2-(2-substituted benzyl)-6-methoxytetralones. Eur J Med Chem 45: 4427–4434.
Jaaskelainen T, Knekt P, Marniemi J, et al, 2013 Vitamin D status is associated with sociodemographic factors, lifestyle and metabolic health. Eur J Nutr 52: 513–525.
Thuesen B, Husemoen L, Fenger M, et al, 2012 Determinants of vitamin D status in a general population of Danish adults. Bone 50: 605–610.
Scragg R, Holdaway I, Jackson R, Lim T, 1992 Plasma 25-hydroxyvitamin D3 and its relation to physical activity and other heart disease risk factors in the general population. Ann Epidemiol 2: 697–703.
Jungert A, Neuhauser-Berthold M, 2013 Dietary vitamin D intake is not associated with 25-hydroxyvitamin D3 or parathyroid hormone in elderly subjects, whereas the calcium-to-phosphate ratio affects parathyroid hormone. Nutr Res 33: 661–667.
Banihosseini SZ, Baheiraei A, Shirzad N, Heshmat R, Mohsenifar A, 2013 The effect of cigarette smoke exposure on vitamin D level and biochemical parameters of mothers and neonates. J Diabetes Metab Disord 12: 19.
Jorde R, Sneve M, Emaus N, Figenschau Y, Grimnes G, 2010 Cross-sectional and longitudinal relation between serum 25-hydroxyvitamin D and body mass index: the Tromso study. Eur J Nutr 49: 401–407.
Melamed ML, Michos ED, Post W, Astor B, 2008 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168: 1629–1637.
Nguyen HT, von Schoultz B, Nguyen TV, et al, 2012 Vitamin D deficiency in northern Vietnam: prevalence, risk factors and associations with bone mineral density. Bone 51: 1029–1034.
Benjamin A, Moriakova A, Akhter N, et al, 2009 Determinants of 25-hydroxyvitamin D levels in African-American and Caucasian male veterans. Osteoporos Int 20: 1795–1803.
Mai XM, Chen Y, Camargo CA Jr, Langhammer A, 2012 Cross-sectional and prospective cohort study of serum 25-hydroxyvitamin D level and obesity in adults: the HUNT study. Am J Epidemiol 175: 1029–1036.
Young KA, Engelman CD, Langefeld CD, et al, 2009 Association of plasma vitamin D levels with adiposity in Hispanic and African Americans. J Clin Endocrinol Metab 94: 3306–3313.
Smith GR, Collinson PO, Kiely PD, 2005 Diagnosing hypovitaminosis D: serum measurements of calcium, phosphate, and alkaline phosphatase are unreliable, even in the presence of secondary hyperparathyroidism. J Rheumatol 32: 684–689.
Khashayar P, Meybodi HR, Homami MR, et al, 2011 The discriminative value of various biochemical parameters in detecting varying degrees of vitamin D deficiency in the Iranian population. Clin Lab 57: 163–170.
Lappin D, Sherrabeh S, Jenkins WM, et al, 2007 Effect of smoking on serum RANKL and OPG in sex, age and clinically matched supportive-therapy periodontitis patients. J Clin Periodontol 34: 271–277.
Seamans KM, Cashman KD, 2009 Existing and potentially novel functional markers of vitamin D status: a systematic review. Am J Clin Nutr 89: 1997S–2008S.
Lu HK, Zhang Z, Ke YH, et al, 2012 High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover. PLoS One 7: e47264.
Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G, 2000 Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15: 1856–1862.
Roy DK, Berry JL, Pye SR, et al, 2007 Vitamin D status and bone mass in UK South Asian women. Bone 40: 200–204.
Lowe NM, Mitra SR, Foster PC, Bhojani I, McCann JF, 2010 Vitamin D status and markers of bone turnover in Caucasian and South Asian postmenopausal women living in the UK. Br J Nutr 103: 1706–1710.
Solarz K, Kopeć A, Pietraszewska J, Majda F, Słowińska-Lisowska M, Mędras M, 2014 An evaluation of the levels of 25-hydroxyvitamin D3 and bone turnover markers in professional football players and in physically inactive men. Physiol Res 63: 237–243.
Gallagher J, Jindal P, Smith L, 2014 Vitamin D does not increase calcium absorption in young women: a randomized clinical trial. Bone Miner Res 29: 1081–1087.
Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B, 2004 Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med 116: 634–639.
Farrell CJ, Martin S, McWhinney B, Straub I, Williams P, Herrmann M, 2012 State-of-the-art vitamin D assays: a comparison of automated immunoassays with liquid chromatography-tandem mass spectrometry methods. Clin Chem 58: 531–542.
Costelloe SJ, Woolman E, Rainbow S, et al, 2009 Is high-throughput measurement of 25-hydroxyvitamin D3 without 25-hydroxyvitamin D2 appropriate for routine clinical use? Ann Clin Biochem 46: 86–87; author reply 87–88.
Snellman G, Melhus H, Gedeborg R, et al, 2010 Determining vitamin D status: a comparison between commercially available assays. PLoS One 5: e11555.
de la Hunty A, Wallace AM, Gibson S, Viljakainen H, Lamberg-Allardt C, Ashwell M, 2010 UK Food Standards Agency Workshop Consensus Report: the choice of method for measuring 25-hydroxyvitamin D to estimate vitamin D status for the UK National Diet and Nutrition Survey. Br J Nutr 104: 612–619.
Major JM, Graubard BI, Dodd KW, et al, 2013 Variability and reproducibility of circulating vitamin D in a nationwide U.S. population. J Clin Endocrinol Metab 98: 97–104.
Author information
Authors and Affiliations
Corresponding author
Additional information
Authors contributed equally to this manuscript
Rights and permissions
About this article
Cite this article
Kassi, E.N., Stavropoulos, S., Kokkoris, P. et al. Smoking is a significant determinant of low serum vitamin D in young and middle-aged healthy males. Hormones 14, 241–250 (2015). https://doi.org/10.14310/horm.2002.1521
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.14310/horm.2002.1521