Skip to main content
SpringerLink
Log in

Association between vitamin D and bone mineral density in Japanese adults: the Unzen study

  • Original Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

We showed an association between serum concentrations of vitamin D and bone health among community-dwelling adults in Japan after adjustment for confounding factors, with 730 participants in a city, with concentrations of 25(OH) vitamin D, and with parameters of quantitative ultrasound.

Purpose

The primary objective of this study was to examine the correlation between serum 25-hydroxyvitamin D (25(OH)D) concentration and bone indicators as measured by quantitative ultrasound in middle-aged and older Japanese adults living in low-latitude seaside areas during summer and autumn.

Methods

We conducted a cross-sectional study, the Unzen study, on community-dwelling Japanese adults who participated to periodic health examinations between 2011 and 2013 (during the months of May to November).

Results

A total of 301 men (mean (SD) age, 67.9 (8.2) years; range, 50–92 years) and 429 women (mean (SD) age, 67.9 (7.7); range, 50–89 years) participated in this study. Serum 25(OH)D levels and quantitative ultrasound parameters (broadband ultrasound (BUA), speed of sound (SOS), and stiffness index of the calcaneus were measured for the participants. We excluded two men and 28 women from the 730 participants because they were on medication for osteoporosis. So, 299 men and 401 women were included in the final data analysis. The prevalence of vitamin D insufficiency (< 30 ng/ml) was very high: 71.9% in men and 95.5% in women. In women, the log(25(OH)D) positively and significantly correlated with SOS (p = 0.011) and stiffness index (p = 0.028) but not with BUA (p = 0.176). In men, the log(25(OH)D) did not correlate with the BUA, SOS, or stiffness index (p = 0.218, 0.420, and 0.262, respectively).

Conclusions

Serum 25(OH)D levels were associated with SOS or stiffness index in women but not in men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets are available from the corresponding author in the case of reasonable request. The datasets of the Unzen study analyzed in the current study are not publicly available because the datasets include in-depth information and we are planning to report other association studies using the same dataset.

References

  1. Takeyama K, Kitanaka S, Sato T, Kobori M, Yanagisawa J, Kato S (1997) 25-Hydroxyvitamin D3 1alpha-hydroxylase and vitamin D synthesis. Science 277(5333):1827–1830

    Article  CAS  Google Scholar 

  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(4):477–501

    Article  CAS  Google Scholar 

  3. Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G, Ragi-Eis S, Chandler J (2006) The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med 260(3):245–254

    Article  CAS  Google Scholar 

  4. Nakamura K, Tsugawa N, Saito T, Ishikawa M, Tsuchiya Y, Hyodo K, Maruyama K, Oshiki R, Kobayashi R, Nashimoto M, Yoshihara A, Ozaki R, Okano T, Yamamoto M (2008) Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi Study. Bone 42(2):271–277

    Article  CAS  Google Scholar 

  5. 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(11):2775–2787

    Article  CAS  Google Scholar 

  6. Tamaki J, Iki M, Sato Y, Kajita E, Nishino H, Akiba T, Matsumoto T, Kagamimori S, J.S. Group (2017) Total 25-hydroxyvitamin D levels predict fracture risk: results from the 15-year follow-up of the Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporos Int 28(6):1903–1913

    Article  CAS  Google Scholar 

  7. Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R, Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O (2015) Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 74:10–17

    Article  CAS  Google Scholar 

  8. Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16(8):1408–1415

    Article  CAS  Google Scholar 

  9. Malavolta N, Pratelli L, Frigato M, Mule R, Mascia ML, Gnudi S (2005) The relationship of vitamin D status to bone mineral density in an Italian population of postmenopausal women. Osteoporos Int 16(12):1691–1697

    Article  CAS  Google Scholar 

  10. Yamauchi M, Kaji H, Nawata K, Takaoka S, Yamaguchi T, Sugimoto T (2011) Role of parathyroid hormone in bone fragility of postmenopausal women with vitamin D insufficiency. Calcif Tissue Int 88(5):362–369

    Article  CAS  Google Scholar 

  11. Choi SW, Kweon SS, Choi JS, Rhee JA, Lee YH, Nam HS, Jeong SK, Park KS, Ryu SY, Song HR, Shin MH (2016) The association between vitamin D and parathyroid hormone and bone mineral density: the Dong-gu Study. J Bone Miner Metab 34(5):555–563

    Article  CAS  Google Scholar 

  12. Liu M, Yao X, Zhu Z (2019) Associations between serum calcium, 25(OH)D level and bone mineral density in older adults. J Orthop Surg Res 14(1):458

    Article  Google Scholar 

  13. Moayyeri A, Adams JE, Adler RA, Krieg MA, Hans D, Compston J, Lewiecki EM (2012) Quantitative ultrasound of the heel and fracture risk assessment: an updated meta-analysis. Osteoporos Int 23(1):143–153

    Article  CAS  Google Scholar 

  14. Krieg MA, Cornuz J, Ruffieux C, Van Melle G, Buche D, Dambacher MA, Hans D, Hartl F, Hauselmann HJ, Kraenzlin M, Lippuner K, Neff M, Pancaldi P, Rizzoli R, Tanzi F, Theiler R, Tyndall A, Wimpfheimer C, Burckhardt P (2006) Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study. J Bone Miner Res 21(9):1457–1463

    Article  Google Scholar 

  15. Grigoriou EV, Trovas G, Papaioannou N, Makras P, Kokkoris P, Dontas I, Makris K, Tournis S, Dedoussis GV (2018) Serum 25-hydroxyvitamin D status, quantitative ultrasound parameters, and their determinants in Greek population. Arch Osteoporos 13(1):111

    Article  Google Scholar 

  16. Kauppi M, Impivaara O, Maki J, Heliovaara M, Marniemi J, Montonen J, Jula A (2009) Vitamin D status and common risk factors for bone fragility as determinants of quantitative ultrasound variables in a nationally representative population sample. Bone 45(1):119–124

    Article  CAS  Google Scholar 

  17. Tanaka N, Arima K, Nishimura T, Tomita Y, Mizukami S, Okabe T, Abe Y, Kawashiri SY, Uchiyama M, Honda Y, Tsujimoto R, Kanagae M, Osaki M, Aoyagi K (2020) Vitamin K deficiency, evaluated with higher serum ucOC, was correlated with poor bone status in women. J Physiol Anthropol 39(1):9

    Article  Google Scholar 

  18. Cepollaro C, Gonnelli S, Montagnani A, Caffarelli C, Cadirni A, Martini S, Nuti R (2005) In vivo performance evaluation of the Achilles Insight QUS device. J Clin Densitom 8(3):341–346

    Article  Google Scholar 

  19. Okazaki R, Ozono K, Fukumoto S, Inoue D, Yamauchi M, Minagawa M, Michigami T, Takeuchi Y, Matsumoto T, Sugimoto T (2017) Assessment criteria for vitamin D deficiency/insufficiency in Japan: proposal by an expert panel supported by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research and the Japan Endocrine Society [Opinion]. J Bone Miner Metab 35(1):1–5

    Article  CAS  Google Scholar 

  20. Jungert A, Neuhäuser-Berthold M (2017) No associations of 25-hydroxycholecalciferol and parathyroid hormone concentrations with calcaneal bone characteristics in community-dwelling elderly subjects: a cross-sectional study. J Nutr Health Aging 21(6):733–742

    Article  CAS  Google Scholar 

  21. Sohl E, de Jongh RT, Swart KM, Enneman AW, van Wijngaarden JP, van Dijk SC, Ham AC, van der Zwaluw NL, Brouwer-Brolsma EM, van der Velde N, de Groot CP, te Velde SJ, Lips P, van Schoor NM (2015) The association between vitamin D status and parameters for bone density and quality is modified by body mass index. Calcif Tissue Int 96(2):113–122

    Article  CAS  Google Scholar 

  22. Njeh CF, Fuerst T, Diessel E, Genant HK (2001) Is quantitative ultrasound dependent on bone structure? A reflection. Osteoporos Int 12(1):1–15

    CAS  PubMed  Google Scholar 

  23. Bullo M, Estruch R, Salas-Salvado J (2011) Dietary vitamin K intake is associated with bone quantitative ultrasound measurements but not with bone peripheral biochemical markers in elderly men and women. Bone 48(6):1313–1318

    Article  CAS  Google Scholar 

  24. Gluer CC, Wu CY, Jergas M, Goldstein SA, Genant HK (1994) Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int 55(1):46–52

    Article  CAS  Google Scholar 

  25. De Terlizzi F, Battista S, Cavani F, Cane V, Cadossi R (2000) Influence of bone tissue density and elasticity on ultrasound propagation: an in vitro study. J Bone Miner Res 15(12):2458–2466

    Article  Google Scholar 

  26. Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87(4):1080s-s1086

    Article  CAS  Google Scholar 

  27. Scragg R, Camargo CA Jr (2008) Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 168(6):577–586; discussion 587–91

Download references

Funding

This work was supported by JSPS KAKENHI Grant No. JP23370105.

Author information

Authors and Affiliations

  1. Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Yuzo Honda, Kazuhiko Arima, Takayuki Nishimura, Yoshihito Tomita, Satoshi Mizukami, Yasuyo Abe, Natsumi Tanaka, Michiko Kojima, Mitsuo Kanagae & Kiyoshi Aoyagi

  2. Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan

    Takayuki Nishimura

  3. School of Rehabilitation, Department of Physical Therapy, Tokyo Professional University of Health Science, Tokyo, Japan

    Yoshihito Tomita

  4. Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan

    Tsung-Ping Jeng

  5. Ken-Hoku Health Care Office, Nagasaki, Japan

    Hisashi Goto

  6. Medical Policy Division, Nagasaki Prefectural Government, Nagasaki, Japan

    Maiko Hasegawa

  7. Ken-Nan Health Care Office, Nagasaki, Japan

    Youko Sou

  8. Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Ritsu Tsujimoto & Makoto Osaki

  9. Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan

    Mitsuo Kanagae

Authors
  1. Yuzo Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhiko Arima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takayuki Nishimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshihito Tomita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Satoshi Mizukami
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuyo Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Natsumi Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michiko Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tsung-Ping Jeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hisashi Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Maiko Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Youko Sou
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ritsu Tsujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Mitsuo Kanagae
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Makoto Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Kiyoshi Aoyagi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study design: YH and KA. Conducted the study: MO and KA. Data collection/analysis: YH, KA, TN, YT, SM, YA, NT, MK, TPJ, HG, MH, YS, RT, and MK. Statistical analysis: KA. Drafting the manuscript: YH, KA, TN, TPJ, and KA. Revising the manuscript content: YT, SM, YA, NT, MK, HG, MH, YS, RT, MK, MO, and KA. Approving the final version of the manuscript: All authors. KA takes responsibility for the integrity of the data analysis.

Corresponding author

Correspondence to Kazuhiko Arima.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Honda, Y., Arima, K., Nishimura, T. et al. Association between vitamin D and bone mineral density in Japanese adults: the Unzen study. Arch Osteoporos 16, 127 (2021). https://doi.org/10.1007/s11657-021-00984-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11657-021-00984-9

Keywords

Search

Navigation