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Archives of Osteoporosis

, 8:124 | Cite as

Vitamin D insufficiency together with high serum levels of vitamin A increases the risk for osteoporosis in postmenopausal women

  • J. M. Mata-Granados
  • J. R. Cuenca-Acevedo
  • M. D. Luque de Castro
  • M. F. HolickEmail author
  • J. M. Quesada-Gómez
Original Article

Abstract

Summary

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.

Purpose

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

Design

The design is a cross-sectional study of 232 healthy postmenopausal women.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Osteoporosis Vitamin D Vitamin A Bone mineral density 25-Hydroxyvitamin D 

Notes

Acknowledgments

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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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • J. M. Mata-Granados
    • 1
    • 2
  • J. R. Cuenca-Acevedo
    • 3
  • M. D. Luque de Castro
    • 2
  • M. F. Holick
    • 4
    Email author
  • J. M. Quesada-Gómez
    • 1
    • 3
  1. 1.Department of I+D+ISanyres GroupCórdobaSpain
  2. 2.Department of Analytical ChemistryUniversity of CórdobaCórdobaSpain
  3. 3.Mineral Metabolism Unit RETICEF, EndocrinologyReina Sofía HospitalCórdobaSpain
  4. 4.Vitamin D Laboratory, Section of Endocrinology, Diabetes, and Nutrition, Department of MedicineBoston University Medical CenterBostonUSA

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