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Optimal Serum Concentration of 25-Hydroxyvitamin D for Bone Health in Older Korean Adults

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Abstract

Optimal vitamin D concentrations for bone health have not been determined in the Korean population. The aim of this study was to define serum 25-hydroxyvitamin D (25[OH]D) concentrations that indicate insufficiency among older Korean adults as measured by serum intact parathyroid hormone (iPTH) concentrations and bone mineral density (BMD). We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3), which was conducted in Korea in 2009. We enrolled 1,451 men and 1,870 women aged 49 years and above. After adjusting for variables that could potentially affect serum 25(OH)D concentrations, we found that serum iPTH concentrations began to increase at serum 25(OH)D concentrations below 12.1 ng/mL (30.2 nmol/L). In addition, total-femur BMD increased until serum 25(OH)D concentrations dropped below 20.4 ng/mL (50.9 nmol/L); no significant changes were observed thereafter. Assuming that serum 25(OH)D concentrations below 12.1 and 20.4 ng/mL represent vitamin D insufficiency, the prevalences of vitamin D insufficiency were 8.7 and 50.4 % in men and 17.9 and 66.3 % in women, respectively. Serum 25(OH)D cutoff values of 12.1 ng/mL (OR = 1.26) and 20.4 ng/mL (OR = 1.54) were associated with osteoporosis (P < 0.01); osteoporosis was not associated with a 25(OH)D cutoff value of 30 ng/mL (75.0 nmol/L). In conclusion, serum 25(OH)D concentrations of 20 ng/mL might be sufficient for bone health in older Korean adults.

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References

  1. 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 Int Med 260:245–254

    Article  CAS  Google Scholar 

  2. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  PubMed  CAS  Google Scholar 

  3. Holick MF (2006) High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81:353–373

    Article  PubMed  CAS  Google Scholar 

  4. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28

    PubMed  CAS  Google Scholar 

  5. Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  PubMed  CAS  Google Scholar 

  6. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL et al (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  PubMed  CAS  Google Scholar 

  7. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443

    Article  PubMed  CAS  Google Scholar 

  8. Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE (2005) Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90:3215–3224

    Article  PubMed  CAS  Google Scholar 

  9. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    Article  PubMed  CAS  Google Scholar 

  10. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL et al (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58

    Article  PubMed  CAS  Google Scholar 

  11. Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381

    Article  PubMed  CAS  Google Scholar 

  12. Institute of Medicine (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academies Press, Washington DC

    Google Scholar 

  13. Heaney RP, Dowell MS, Hale CA, Bendich A (2003) Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22:142–146

    PubMed  CAS  Google Scholar 

  14. Bolland MJ, Grey AB, Ames RW, Mason BH, Horne AM, Gamble GD, Reid IR (2007) The effects of seasonal variation of 25-hydroxyvitamin D and fat mass on a diagnosis of vitamin D sufficiency. Am J Clin Nutr 86:959–964

    PubMed  CAS  Google Scholar 

  15. Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341

    Article  PubMed  CAS  Google Scholar 

  16. Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244

    Article  PubMed  Google Scholar 

  17. Sai AJ, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–E446

    Article  PubMed  CAS  Google Scholar 

  18. Rosen CJ (2011) Clinical practice. Vitamin D insufficiency. N Engl J Med 364:248–254

    Article  PubMed  CAS  Google Scholar 

  19. Ensrud KE, Taylor BC, Paudel ML, Cauley JA, Cawthon PM, Cummings SR, Fink HA, Barrett-Connor E, Zmuda JM et al (2009) Serum 25-hydroxyvitamin D levels and rate of hip bone loss in older men. J Clin Endocrinol Metab 94:2773–2780

    Article  PubMed  CAS  Google Scholar 

  20. Nakamura K, Nashimoto M, Tsuchiya Y, Saito T, Nishiwaki T, Ueno K, Okuda Y, Oshiki R, Yamamoto M (2006) Threshold value of serum 25-hydroxyvitamin D concentration in relation to elevated serum parathyroid hormone concentrations in elderly Japanese women. J Bone Miner Metab 24:395–400

    Article  PubMed  CAS  Google Scholar 

  21. Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C et al (2010) Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res 25:305–312

    Article  PubMed  CAS  Google Scholar 

  22. Poole KE, Compston JE (2006) Osteoporosis and its management. BMJ 333:1251–1256

    Article  PubMed  CAS  Google Scholar 

  23. Raso AA, Navarra SV, Li-Yu J, Torralba TP (2009) Survey of vitamin D levels among post-menopausal Filipino women with osteoporosis. Int J Rheum Dis 12:225–229

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was performed using raw data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), which was conducted by the Korean Centers for Disease Control and Prevention. This study was supported in part by a grant from the Clinical Research Institute, Kyung Hee University Hospital at Gangdong, in 2010 (KHNMCCRI-2010-001).

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, #149, Sangil-dong, Kangdong-ku, Seoul, 134-727, Korea

    You-Cheol Hwang, In-Kyung Jeong, Kyu Jeung Ahn & Ho Yeon Chung

  2. Department of Statistics, Dongguk University-Seoul, Seoul, Korea

    Hong-Yup Ahn

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  1. You-Cheol Hwang
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  2. Hong-Yup Ahn
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  3. In-Kyung Jeong
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  4. Kyu Jeung Ahn
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Correspondence to Ho Yeon Chung.

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The authors have stated that they have no conflict of interest.

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Hwang, YC., Ahn, HY., Jeong, IK. et al. Optimal Serum Concentration of 25-Hydroxyvitamin D for Bone Health in Older Korean Adults. Calcif Tissue Int 92, 68–74 (2013). https://doi.org/10.1007/s00223-012-9669-3

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  • DOI: https://doi.org/10.1007/s00223-012-9669-3

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