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High Serum Retinol as a Relevant Contributor to Low Bone Mineral Density in Postmenopausal Osteoporotic Women

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Abstract

There is controversial information about the impact of vitamin A on bone. Some epidemiological studies show that excessive intake of vitamin A, or an excess of serum vitamin A, has related with adverse impact on bone mass; however, other studies did not find these links, and some authors have proposed that this vitamin might promote a better bone health. The present work aims to contribute to clarify the real role of vitamin A in bone tissue. For this purpose, a cross-sectional study of 154 osteoporotic non-treated postmenopausal women (> 65 years old) was carried out. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. We assessed concentrations of serum retinol, osteocalcin, parathyroid hormone, alkaline phosphatase, calcium, and phosphorus. We also studied demographic and anthropometric parameters. Spearman’s correlations between retinol levels and other variables found negative correlations with BMD in both lumbar spine (R = − 0.162, P < 0.01) and femoral neck (R = − 0.182, P < 0.01), as well as alkaline phosphatase (R = − 0.110; P < 0.05) and phosphorus (R = − 0.110; P < 0.05). A positive correlation between retinol and fertile window was observed (R = 0.158; P < 0.01). After multivariable adjustment, we still found a negative correlation between serum retinol and BMD, both at the lumbar spine (R = − 0.210; P < 0.01) and at the femoral neck (R = − 0.324, P < 0.001). It is concluded that elevated serum-retinol levels are associated with an increased risk of low bone mass and thus with osteoporotic fractures. Therefore, osteoporosis-risk assessment should include quantification of serum metabolite of vitamin A.

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Abbreviations

WHO:

World Health Organization

BMD:

Bone mineral density

DEXA:

Dual-energy X-ray absorptiometry

HPLC:

High-performance liquid chromatography

BMI:

Body mass index

RDA:

Recommended dietary allowances

FNB:

Food and nutrition board

RXR:

Nuclear transcription factor

VDR:

Vitamin D receptor

RAR:

Retinoic acid receptor

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Acknowledgements

The authors are indebted to all participants and the staff of the “Maimonides Biomedical Research Institute of Cordoba” (IMIBIC) for their dedicated and conscientious collaboration and assistance. Also, we are grateful to the Thematic Network of Corporative Research in Aging and Frailty (RETICEF) and CIBERFES for its scientific aid.

Funding

P06-FQM-01515 Excellence Project from “Consejería de Innovación, Ciencia y Empresa,” “Junta de Andalucía,” CM0010/05 FIS Project from “Instituto de Salud Carlos III,” SAF2005-05254 Project from “Ministerio de Educación y Cultura,” PAIDI group CTS-413 and PAIDI group FQM-227 of “Junta de Andalucía” (Spain). RETICEF & CIBERFES, “Instituto de Salud Carlos III.”

Author information

Author notes

  1. Cristina Navarro-Valverde and Javier Caballero-Villarraso have equally contributed to the development of this work.

Authors and Affiliations

  1. UGC Cardiología, Hospital Universitario Virgen de Valme, Seville, Spain

    Cristina Navarro-Valverde

  2. IMIBIC (Instituto Maimónides de Investigación Biomédica de Córdoba)/Hospital Universitario Reina Sofía/ Universidad de Córdoba & RETICEF, CIBERFES (ISCIII), Córdoba, Spain

    Javier Caballero-Villarraso, José M. Mata-Granados, Antonio Casado-Díaz & José Manuel Quesada-Gómez

  3. Unidad Metabólica Ósea, Hospital Universitario Insular & RETICEF, Las Palmas, Spain

    Manuel Sosa-Henríquez

  4. Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau & RETICEF (ISCIII), Barcelona, Spain

    Jorge Malouf-Sierra

  5. Servicio de Medicina Interna (Hospital del Mar Medical Research Institute), Universitat Autònoma de Barcelona & RETICEF, CIBERFES (ISCIII), Barcelona, Spain

    Xavier Nogués-Solán

  6. Fundación para la Investigación Biomédica, Servicio de Geriatría, Hospital Universitario de Getafe & RETICEF, CIBERFES (ISCIII), Madrid, Spain

    Leocadio Rodríguez-Mañas

  7. Laboratorios Almirall, Barcelona, Spain

    Xavier Cortés-Gil

  8. Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Barcelona, Spain

    Joaquín Delgadillo-Duarte

Authors
  1. Cristina Navarro-Valverde
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  2. Javier Caballero-Villarraso
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  3. José M. Mata-Granados
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  6. Jorge Malouf-Sierra
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  7. Xavier Nogués-Solán
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  8. Leocadio Rodríguez-Mañas
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  9. Xavier Cortés-Gil
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  10. Joaquín Delgadillo-Duarte
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  11. José Manuel Quesada-Gómez
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Corresponding author

Correspondence to Javier Caballero-Villarraso.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be considered as a potential conflict of interest.

Human and Animal Rights and Informed Consent

The study was approved by the regional ‘CEIC’ (Clinical Research Ethics Committee) of Córdoba due to Reina Sofía Univertity of Córdoba was the coordinating center. Other hospitals participating in the study, according to the regulations, subsequently adhered after get the permission from their respective Clinical Research Ethics Committees. They guarantee the clinical research is performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Navarro-Valverde, C., Caballero-Villarraso, J., Mata-Granados, J.M. et al. High Serum Retinol as a Relevant Contributor to Low Bone Mineral Density in Postmenopausal Osteoporotic Women. Calcif Tissue Int 102, 651–656 (2018). https://doi.org/10.1007/s00223-017-0379-8

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  • DOI: https://doi.org/10.1007/s00223-017-0379-8

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