Vitamin D insufficiency together with high serum levels of vitamin A increases the risk for osteoporosis in postmenopausal women
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Postmenopausal women who were vitamin D deficient and had high serum levels of retinol had an eight times higher risk of having osteoporosis. A high retinol level together with vitamin D deficiency/insufficiency is an additional risk factor for osteoporosis.
The aim of this study was to evaluate the association between vitamin D deficiency/insufficiency and excess of vitamin A intake as an osteoporosis risk factor in healthy postmenopausal women
The design is a cross-sectional study of 232 healthy postmenopausal women.
Bone mass was evaluated by dual energy X-ray absorptiometry. Serum calcium, albumin phosphorus, creatinine, total high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and triglycerides analyzed by standard methods and retinol and 25-hydroxyvitamin D [25(OH)D] measured by an online solid-phase extraction coupled with high-pressure liquid chromatography–ultraviolet detection.
Prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] was 70.1 %; 14.3 % had a 25(OH)D < 10 ng/mL, and 23.6 % had insufficiency [25(OH)D 21–29 ng/mL]. Prevalence of high serum levels of retinol (>80 μg/dL) was 36.4 %. Among subjects with 25(OH)D <20 ng/mL (n = 152), 60.4 % (n = 92) had serum levels of retinol > 80 μg/dL. Bone density measurements revealed that the risk of osteoporosis was ~8 times higher in women with the highest retinol levels, as compared with women with the lowest retinol levels. In women with 25(OH)D < 20 ng/mL, the risk for osteoporosis increased substantially in women who had the highest blood levels of retinol compared to the women with lowest retinol levels.
Higher retinol levels together with vitamin D deficiency could be a significant additional risk factor for osteoporosis, underscoring the need for improved physician and public education regarding optimization of vitamin D status in postmenopausal women and developing policies to avoid high serum levels of vitamin A.
KeywordsOsteoporosis Vitamin D Vitamin A Bone mineral density 25-Hydroxyvitamin D
This study was supported by grants CS 0200/2008, P06-FQM-01515, and SAF2005-05254 and teams PAI CTS-413 and PAI FQM-227 of Junta de Andalucía and Sanyres 21, Córdoba (Spain).
Conflicts of interest
JMMG, JRCA, MDLC, and JMQG have no conflict of interest. MFH is a consultant for Merck, Sanofi-Aventis, P&G, Quest Diagnostics, and Novartis.
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