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Osteoporosis International

, Volume 26, Issue 1, pp 151–161 | Cite as

Serum levels of 25-hydroxyvitamin D and the occurrence of musculoskeletal diseases: a 3-year follow-up to the road study

  • N. YoshimuraEmail author
  • S. Muraki
  • H. Oka
  • K. Nakamura
  • H. Kawaguchi
  • S. Tanaka
  • T. Akune
Original Article

Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

25-Hydroxyvitamin D Epidemiology Incidence Osteoarthritis Osteoporosis Population-based cohort study 

Notes

Acknowledgments

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.

References

  1. 1.
    Ministry of Health. Labour and Welfare (2010) Outline of the results of the National Livelihood Survey 2010. http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/4-2.html. Accessed 12 September 2012
  2. 2.
    Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501PubMedCrossRefGoogle Scholar
  3. 3.
    Bischoff-Ferrari HA, Zhang Y, Kiel DP, Felson DT (2005) Positive association between serum 25-hydroxyvitamin D level and bone density in osteoarthritis. Arthritis Rheum 53:821–826PubMedCrossRefGoogle Scholar
  4. 4.
    Bischoff-Ferrari HA, Kiel DP, Dawson-Hughes B, Orav JE, Li R, Spiegelman D, Dietrich T, Willett WC (2009) Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. J Bone Miner Res 24:935–942PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820PubMedCrossRefGoogle Scholar
  6. 6.
    Hanley DA, Cranney A, Jones G, Whiting SJ, Leslie WD, Cole DE, Atkinson SA, Josse RG, Feldman S, Kline GA, Rosen C, Guidelines Committee of the Scientific Advisory Council of Osteoporosis Canada (2010) Vitamin D in adult health and disease: a review and guideline statement from osteoporosis Canada. CMAJ 182:E610–618PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE, Josse RG, Lips P, Morales-Torres J, Yoshimura N (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21:1151–1154PubMedCrossRefGoogle Scholar
  8. 8.
    Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G (2009) Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum 60:1381–1389PubMedCrossRefGoogle Scholar
  9. 9.
    Chaganti RK, Parimi N, Cawthon P, Dam TL, Nevitt MC, Lane NE (2010) Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study. Arthritis Rheum 62:511–514PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    McAlindon TE, Felson DT, Zhang Y, Hannan MT, Aliabadi P, Weissman B (1996) Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med 125:353–359PubMedCrossRefGoogle Scholar
  11. 11.
    Lane NE, Gore LR, Cummings SR, Hochberg MC, Scott JC, Williams EN (1999) Serum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Study of osteoporotic fractures research group. Arthritis Rheum 42:854–860PubMedCrossRefGoogle Scholar
  12. 12.
    Felson DT, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A, Hunter DJ, Amin S, Rogers G, Booth SL (2007) Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum 56:129–136PubMedCrossRefGoogle Scholar
  13. 13.
    Konstari S, Paananen M, Heliövaara M, Knekt P, Marniemi J, Impivaara O, Arokoski J, Karppinen J (2012) Association of 25-hydroxyvitamin D with the incidence of knee and hip osteoarthritis: a 22-year follow-up study. Scand J Rheumatol 41:124–131PubMedCrossRefGoogle Scholar
  14. 14.
    Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628PubMedCrossRefGoogle Scholar
  15. 15.
    Yoshimura N, Muraki S, Oka H, Kawaguchi H, Nakamura K, Akune T (2010) Cohort profile: research on osteoarthritis/osteoporosis against disability study. Int J Epidemiol 39:988–995PubMedCrossRefGoogle Scholar
  16. 16.
    Kobayashi S, Honda S, Murakami K, Sasaki S, Okubo H, Hirota N, Notsu A, Fukui M, Date C (2012) Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. J Epidemiol 22:151–159PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Hollis BW, Kamerud JQ, Selvaag SR, Lorenz JD, Napoli JL (1993) Determination of vitamin D status by radioimmunoassay with an 125I-labeled tracer. Clin Chem 39:529–533PubMedGoogle Scholar
  18. 18.
    World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Tech Rep Ser 843:1–129Google Scholar
  19. 19.
    Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-Hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H, Osteoporosis Diagnostic Criteria Review Committee: Japanese Society for Bone and Mineral Research (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337PubMedCrossRefGoogle Scholar
  20. 20.
    Kellgren JH, Lawrence LS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Yoshimura N, Muraki S, Oka H, Morita M, Yamada H, Tanaka S, Kawaguchi H, Nakamura K, Akune T (2013) Profiles of vitamin D insufficiency and deficiency in Japanese men and women: association with biological, environmental, and nutritional factors and coexisting disorders: the ROAD study. Osteoporos Int 24:2775–2778PubMedCrossRefGoogle Scholar
  22. 22.
    Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M, Tokimura F, Nakamura K, Kawaguchi H, Yoshimura N (2012) Incidence and risk factors for radiographic knee osteoarthritis and knee pain in Japanese men and women: a longitudinal population-based cohort study. Arthritis Rheum 64:1447–1456PubMedCrossRefGoogle Scholar
  23. 23.
    Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M, Tokimura F, Nakamura K, Kawaguchi H, Yoshimura N (2012) Incidence and risk factors for radiographic lumbar spondylosis and lower back pain in Japanese men and women: the ROAD study. Osteoarthr Cartil 20:712–718PubMedCrossRefGoogle Scholar
  24. 24.
    Yoshimura N, Muraki S, Oka H, Kawaguchi H, Nakamura K, Akune T (2011) Biochemical markers of bone turnover as predictors for occurrence of osteoporosis and osteoporotic fractures in men and women: ten-year follow-up of the Taiji cohort study. Mod Rheumatol 21:608–620PubMedCrossRefGoogle Scholar
  25. 25.
    Yoshimura N, Muraki S, Oka H, Mabuchi A, Kinoshita H, Yoshida M, Kawaguchi H, Nakamura K, Akune T (2009) Epidemiology of lumbar osteoporosis and osteoarthritis and their causal relationship—is osteoarthritis a predictor for osteoporosis or vice-versa?: the Miyama study. Osteoporos Int 20:999–1008PubMedCrossRefGoogle Scholar
  26. 26.
    Portal site of Official Statistics of Japan (2010) Population Census 2010. http://www.e-stat.go.jp/SG1/estat/NewListE.do?tid=000001039448. Accessed 17 Aug 2014
  27. 27.
    Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stahelin HB, Theiler R, Dawson-Hughes B (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49PubMedCrossRefGoogle Scholar
  28. 28.
    Bischoff-Ferrari HA, Willett WC, Orav JE, Kiel DP, Dawson-Hughes B (2011) Fall prevention with vitamin D. BMJ 342:d2608CrossRefGoogle Scholar
  29. 29.
    Tanaka S. Kuroda T. Yamazaki Y. Shiraki Y. Yoshimura N. Shiraki M (2013) Serum 25-hydroxyvitamin D below 25 ng/mL is a risk factor for long bone fracture comparable to bone mineral density in Japanese postmenopausal women. J Bone Miner Metab. doi:  10.1007/s00774-013-0520-3
  30. 30.
    Bergink AP, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA, Pols HA (2009) Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: the Rotterdam study. J Clin Rheumatol 15:230–237PubMedCrossRefGoogle Scholar
  31. 31.
    Oka H, Muraki S, Akune T, Mabuchi A, Suzuki T, Yoshida H, Yamamoto S, Nakamura K, Yoshimura N, Kawaguchi H (2008) Fully automatic quantification of knee osteoarthritis severity on plain radiographs. Osteoarthr Cartil 16:1300–1306PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  • N. Yoshimura
    • 1
    Email author
  • S. Muraki
    • 2
  • H. Oka
    • 1
  • K. Nakamura
    • 3
  • H. Kawaguchi
    • 4
  • S. Tanaka
    • 5
  • T. Akune
    • 3
  1. 1.Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of MedicineThe University of TokyoBunkyo-kuJapan
  2. 2.Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, Graduate School of MedicineThe University of TokyoBunkyo-kuJapan
  3. 3.National Rehabilitation Center for Persons with DisabilitiesTokorozawa CityJapan
  4. 4.JCHO Tokyo Shinjuku Medical CenterShinjyuku-kuJapan
  5. 5.Department of Orthopaedic Surgery, Faculty of MedicineThe University of TokyoBunkyo-kuJapan

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