Osteoporosis International

, Volume 22, Issue 9, pp 2475–2485 | Cite as

The association of serum 25-hydroxyvitamin D with indicators of bone quality in men of Caucasian and African ancestry

  • K. E. Barbour
  • J. M. Zmuda
  • M. J. Horwitz
  • E. S. Strotmeyer
  • R. Boudreau
  • R. W. Evans
  • K. E. Ensrud
  • C. L. Gordon
  • M. A. Petit
  • A. L. Patrick
  • J. A. Cauley
  • Osteoporotic Fractures in Men (MrOS) Research Group
Original Article

Abstract

Summary

We examined the association of serum 25-hydroxyvitamin D [25(OH)D] with indices of bone quality in older men. Positive associations for 25(OH)D and bone mineral density, content, cortical thickness, and axial and polar strength strain indices were observed among Caucasians; however, among men of African descent findings were either null or negative.

Introduction

There are limited data on serum 25(OH)D and bone measures in men of African ancestry. To better understand racial differences in vitamin D status and bone health, a cross-sectional study among 446 Caucasian men in the US and 496 men of African ancestry in Tobago (age ≥ 65 years) was conducted.

Methods

Serum 25(OH)D (liquid chromatography and tandem mass spectrometry) was measured, and peripheral quantitative computed tomography scans were administered. Bone measures estimated included trabecular and cortical volumetric bone mineral density (vBMD), bone mineral content (BMC), bone geometry (cross-sectional area and cortical thickness), and polar and axial strength strain indices (SSIp and SSIx).

Results

Men of African ancestry had higher 25(OH)D than Caucasians (34.7 vs. 27.6 ng/ml, p < 0.01). Among Caucasians, 25(OH)D was positively (p trend < 0.05) associated with cortical vBMD, total BMC, cortical thickness, SSIp, and SSIx at the distal radius after adjustment for potential confounders. Similar patterns were observed at the distal tibia. In contrast, in men of African ancestry, there was an inverse association (p trend < 0.05) between 25(OH)D and the cross-sectional area, and SSIx. Race modified (p for interaction < 0.05) the association between 25(OH)D and total BMC, cross-sectional area, SSIp, SSIx, and trabecular vBMD of the radius. In men of African ancestry, there was evidence of a threshold effect (at approximately 18 ng/ml) for 25(OH)D on tibial total BMC and cortical thickness.

Conclusions

More studies are needed to better comprehend these race differences for 25(OH)D and bone density, geometry, and indices of bone strength.

Keywords

25(OH)D Men pQCT Radius Tibia vBMD 

References

  1. 1.
    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281PubMedCrossRefGoogle Scholar
  2. 2.
    Zadshir A, Tareen N, Pan D, Norris K, Martins D (2005) The prevalence of hypovitaminosis D among US adults: data from the NHANES III. Ethn Dis 15(4 Suppl 5):S5–S101Google Scholar
  3. 3.
    Ensrud KE, Taylor BC, Paudel ML, Cauley JA, Cawthon PM, Cummings SR, Fink HA, Barrett-Connor E, Zmuda JM, Shikany JM, Orwoll ES (2009) Serum 25-hydroxyvitamin D levels and rate of hip bone loss in older men. J Clin Endocrinol Metab 94(8):2773–2780PubMedCrossRefGoogle Scholar
  4. 4.
    Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22(4):477–501PubMedCrossRefGoogle Scholar
  5. 5.
    Khosla S, Amin S, Orwoll E (2008) Osteoporosis in men. Endocr Rev 29(4):441–464PubMedCrossRefGoogle Scholar
  6. 6.
    Hannan MT, Litman HJ, Araujo AB, McLennan CE, McLean RR, McKinlay JB, Chen TC, Holick MF (2008) Serum 25-hydroxyvitamin D and bone mineral density in a racially and ethnically diverse group of men. J Clin Endocrinol Metab 93(1):40–46PubMedCrossRefGoogle Scholar
  7. 7.
    Kuchuk NO, Pluijm SM, van Schoor NM, Looman CW, Smit JH, Lips P (2009) Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab 94(4):1244–1250PubMedCrossRefGoogle Scholar
  8. 8.
    Saquib N, von Mühlen 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(12):1734–1741PubMedCrossRefGoogle Scholar
  9. 9.
    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(6):520–530PubMedCrossRefGoogle Scholar
  10. 10.
    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(9):634–9PubMedCrossRefGoogle Scholar
  11. 11.
    Dennison E, Eastell R, Fall CH, Kellingray S, Wood PJ, Cooper C (1999) Determinants of bone loss in elderly men and women: a prospective population-based study. Osteoporos Int 10(5):384–391PubMedCrossRefGoogle Scholar
  12. 12.
    Melin A, Wilske J, Ringertz H, Saaf M (2001) Seasonal variations in serum levels of 25-hydroxyvitamin D and parathyroid hormone but no detectable change in femoral neck bone density in an older population with regular outdoor exposure. J Am Geriatr Soc 49(9):1190–1196PubMedCrossRefGoogle Scholar
  13. 13.
    Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 15(4):710–20PubMedCrossRefGoogle Scholar
  14. 14.
    Binkley N, Krueger D, Cowgill CS, Plum L, Lake E, Hansen KE, DeLuca HF, Drezner MK (2004) Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. J Clin Endocrinol Metab 89(7):3152–3157PubMedCrossRefGoogle Scholar
  15. 15.
    Lensmeyer GL, Wiebe DA, Binkley N, Drezner MK (2006) HPLC method for 25-hydroxyvitamin D measurement: comparison with contemporary assays. Clin Chem 52(6):1120–1126PubMedCrossRefGoogle Scholar
  16. 16.
    Lips P, Chapuy MC, wson-Hughes B, Pols HA, Holick MF (1999) An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int 9(5):394–7PubMedCrossRefGoogle Scholar
  17. 17.
    Blank JB, Cawthon PM, Carrion-Petersen ML, Harper L, Johnson JP, Mitson E, Delay RR (2005) Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemp Clin Trials 26(5):557–568PubMedCrossRefGoogle Scholar
  18. 18.
    Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26(5):569–585PubMedCrossRefGoogle Scholar
  19. 19.
    Bunker CH, Patrick AL, Konety BR, Dhir R, Brufsky AM, Vivas CA, Becich MJ, Trump DL, Kuller LH (2002) High prevalence of screening-detected prostate cancer among Afro-Caribbeans: the Tobago Prostate Cancer Survey. Cancer Epidemiol Biomark Prev 11(8):726–729Google Scholar
  20. 20.
    Singh RJ, Taylor RL, Reddy GS, Grebe SK (2006) C-3 epimers can account for a significant proportion of total circulating 25-hydroxyvitamin D in infants, complicating accurate measurement and interpretation of vitamin D status. J Clin Endocrinol Metab 91(8):3055–3061PubMedCrossRefGoogle Scholar
  21. 21.
    Sheu Y, Cauley JA, Bunker CH, Wheeler VW, Patrick AL, Gordon CL, Kammerer CM, Zmuda JM (2009) Correlates of trabecular and cortical volumetric BMD in men of African ancestry. J Bone Miner Res 24(12):1960–1968PubMedCrossRefGoogle Scholar
  22. 22.
    Block G, Subar AF (1992) Estimates of nutrient intake from a food frequency questionnaire: the 1987 National Health Interview Survey. J Am Diet Assoc 92(8):969–977PubMedGoogle Scholar
  23. 23.
    Scragg R, Sowers M, Bell C (2007) Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 20(7):713–719PubMedCrossRefGoogle Scholar
  24. 24.
    Prentice A, Schoenmakers I, Jones K, Jarjou L, Goldberg G (2009) Vitamin D deficiency and its health consequence in Africa. Clinical Reviews in Bone and Mineral Metabolism 7:94–106CrossRefGoogle Scholar
  25. 25.
    Lauretani F, Bandinelli S, Russo CR, Maggio M, Di IA, Cherubini A, Maggio D, Ceda GP, Valenti G, Guralnik JM, Ferrucci L (2006) Correlates of bone quality in older persons. Bone 39(4):915–921PubMedCrossRefGoogle Scholar
  26. 26.
    Cosman F, Morgan DC, Nieves JW, Shen V, Luckey MM, Dempster DW, Lindsay R, Parisien M (1997) Resistance to bone resorbing effects of PTH in black women. J Bone Miner Res 12(6):958–966PubMedCrossRefGoogle Scholar
  27. 27.
    Lindsay R, Zhou H, Cosman F, Nieves J, Dempster DW, Hodsman AB (2007) Effects of a one-month treatment with PTH(1-34) on bone formation on cancellous, endocortical, and periosteal surfaces of the human ilium. J Bone Miner Res 22(4):495–502PubMedCrossRefGoogle Scholar
  28. 28.
    Parfitt AM (2002) Parathyroid hormone and periosteal bone expansion. J Bone Miner Res 17(10):1741–1743PubMedCrossRefGoogle Scholar
  29. 29.
    Duan Y, De L, V, Seeman E (1999) Parathyroid hormone deficiency and excess: similar effects on trabecular bone but differing effects on cortical bone. J Clin Endocrinol Metab 84(2):718-22.Google Scholar
  30. 30.
    Dempster DW, Muller R, Zhou H, Kohler T, Shane E, Parisien M, Silverberg SJ, Bilezikian JP (2007) Preserved three-dimensional cancellous bone structure in mild primary hyperparathyroidism. Bone 41(1):19–24PubMedCrossRefGoogle Scholar
  31. 31.
    Jiang Y, Zhao JJ, Mitlak BH, Wang O, Genant HK, Eriksen EF (2003) Recombinant human parathyroid hormone (1-34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res 18(11):1932–1941PubMedCrossRefGoogle Scholar
  32. 32.
    Parisien M, Silverberg SJ, Shane E, de la Cruz L, Lindsay R, Bilezikian JP, Dempster DW (1990) The histomorphometry of bone in primary hyperparathyroidism: preservation of cancellous bone structure. J Clin Endocrinol Metab 70(4):930–938PubMedCrossRefGoogle Scholar
  33. 33.
    Kotowicz MA, Klee GG, Kao PC, O'Fallon WM, Hodgson SF, Cedel SL, Eriksen EF, Gonchoroff DG, Judd HL, Riggs BL (1990) Relationship between serum intact parathyroid hormone concentrations and bone remodeling in type I osteoporosis: evidence that skeletal sensitivity is increased. Osteoporos Int 1(1):14–22PubMedCrossRefGoogle Scholar
  34. 34.
    Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, Jacobs TP, Siris ES, Cafferty M, Parisien MV (1989) Skeletal disease in primary hyperparathyroidism. J Bone Miner Res 4(3):283–91PubMedCrossRefGoogle Scholar
  35. 35.
    Cauley JA, Parimi N, Ensrud KE, Bauer DC, Cawthon PM, Cummings SR, Hoffman AR, Shikany JM, Barrett-Connor E, Orwoll E (2010) Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men. J Bone Miner Res 25(3):545–553PubMedCrossRefGoogle Scholar
  36. 36.
    Bischoff-Ferrari HA (2007) The 25-hydroxyvitamin D threshold for better health. J Steroid Biochem Mol Biol 103(3–5):614–619PubMedCrossRefGoogle Scholar
  37. 37.
    Cauley JA, Lacroix AZ, Wu L, Horwitz M, Danielson ME, Bauer DC, Lee JS, Jackson RD, Robbins JA, Wu C, Stanczyk FZ, LeBoff MS, Wactawski-Wende J, Sarto G, Ockene J, Cummings SR (2008) Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Ann Intern Med 149(4):242–250PubMedGoogle Scholar
  38. 38.
    Sheu Y, Zmuda JM, Boudreau RM, Petit MA, Ensrud KE, Bauer DC, Gordon CL, Orwoll ES, Cauley JA (2010) Bone strength measured by peripheral quantitative computed tomography and the risk of non-vertebral fractures: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res. (in press)Google Scholar
  39. 39.
    Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B (2001) Ten-year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 12(12):989–995PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • K. E. Barbour
    • 1
    • 7
  • J. M. Zmuda
    • 1
  • M. J. Horwitz
    • 2
  • E. S. Strotmeyer
    • 1
  • R. Boudreau
    • 1
  • R. W. Evans
    • 1
  • K. E. Ensrud
    • 3
  • C. L. Gordon
    • 4
  • M. A. Petit
    • 5
  • A. L. Patrick
    • 6
  • J. A. Cauley
    • 1
  • Osteoporotic Fractures in Men (MrOS) Research Group
  1. 1.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  2. 2.Division of Endocrinology and Metabolism at the University of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Minneapolis VA Medical Center, Rheumatology (111 R)MinneapolisUSA
  4. 4.Department of RadiologyMcMaster UniversityHamiltonCanada
  5. 5.School of KinesiologyUniversity of MinnesotaMinneapolisUSA
  6. 6.Tobago Health Studies OfficeScarboroughTrinidad and Tobago
  7. 7.Center for Aging and Population Health Department of EpidemiologyUniversity of PittsburghPittsburghUSA

Personalised recommendations