Serum levels of 25-hydroxyvitamin D and the occurrence of musculoskeletal diseases: a 3-year follow-up to the road study
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Assessment of serum 25-hydroxyvitamin D levels in association with the occurrence of musculoskeletal diseases using a population-based cohort study design revealed that serum 25-hydroxyvitamin D levels could predict the occurrence of osteoporosis at the femoral neck within 3 years, but not the occurrence of knee osteoarthritis or lumbar spondylosis.
The aim of this study is to clarify the association between serum 25-hydroxyvitamin D (25D) levels and occurrence of osteoporosis and osteoarthritis in the general population.
The Research on Osteoarthritis/Osteoporosis Against Disability study, a large-scale population-based cohort study, was performed during 2005–2007. Serum 25D levels were measured in 1,683 participants. Of these, 1,384 individuals (81.9 %) completed a second follow-up survey 3 years later. Osteoporosis was defined according to World Health Organization criteria, in which osteoporosis is diagnosed by T-scores of bone mineral density (BMD) that are 2.5 standard deviations (SD) less than normal BMD. Knee osteoarthritis and lumbar spondylosis were defined as Kellgren–Lawrence grade ≥2, using paired X-ray films. Cumulative incidences were determined according to changes in measurements using World Health Organization criteria for osteoporosis or Kellgren–Lawrence grades for osteoarthritis between the baseline and second survey.
The mean (SD) serum 25D level of the 1,384 participants in both surveys was 23.4 ng/mL (6.5). The annual cumulative incidences of osteoporosis at L2–4 and the femoral neck were 0.76 and 1.83 %/year, respectively. The incidences of knee osteoarthritis and lumbar spondylosis were 3.3 and 11.4 %/year, respectively. After adjusting for potential associated factors, logistic regression analyses revealed that the odds ratio for the occurrence of femoral neck osteoporosis significantly decreased as serum 25D levels increased (+1 SD; odds ratio 0.67; 95 % confidence interval 0.49–0.92; p = 0.014).
Higher serum 25D levels may prevent the occurrence of osteoporosis at the femoral neck, but not knee osteoarthritis, lumbar spondylosis, or osteoporosis at L2–4.
Keywords25-Hydroxyvitamin D Epidemiology Incidence Osteoarthritis Osteoporosis Population-based cohort study
This work was supported by the Grants-in-Aid for Scientific Research to NY (B23390172 and B20390182), to TA (C20591737), and to SM (C20591774); for Young Scientists to HO (A18689031); and for Collaborating Research with NSF to NY (Director; 08033011-00262) from the Ministry of Education, Culture, Sports, Science and Technology and by H17-Men-eki-009 (Director, KN), H18-Choujyu-037 (Director, TN), H20-Choujyu-009 (Director, NY), H23-Chojyu-002 (Director, TA), H25-Nanchi-to (Men)-005 (Director, ST), and H25-Chojyu-007 (Director, NY) from the Ministry of Health, Labour and Welfare in Japan. This study was also supported by grants from the Japan Osteoporosis Society (NY, SM, HO, and TA) and by research aid from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006-1 and 2010-2; Director, HK). The authors wish to thank Dr. Takako Nojiri and Mr. Kazuhiro Hatanaka of the Gobo Public Health Centre; Dr. Naoki Hirabayashi of the Kawakami Clinic, Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Kumiko Shinou, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, Ms. Ikuyo Ueyama, Mrs. Michiko Mori, Mrs. Hisayo Sugimoto, and other members of the public office in Hidakagawa Town; Dr. Shinji Matsuda of the Shingu Public Health Centre; and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mr. Shoichi Shimoichi, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji, and other members of the public office in Taiji Town for their assistance in locating and scheduling participants for examinations. We also thank Ms. Kyoko Yoshimura, Mrs. Toki Sakurai, and Mrs. Saeko Sahara for their assistance with data reduction and administration.
Conflicts of interest
Noriko Yoshimura, Shigeyuki Muraki, Hiroyuki Oka, Kozo Nakamura, Hiroshi Kawaguchi, Sakae Tanaka, and Toru Akune declare that they have no conflict of interest.
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