J Tamaki1, M Iki2, Y Sato3, E Kajita4, H Nishino5, T Akiba6, T Matsumoto7, S Kagamimori8. 1. Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan. jtamaki@osaka-med.ac.jp. 2. Department of Public Health, Faculty of Medicine, Kindai University, 377-2 Oono-higashi, Osakasayama, Japan. 3. Department of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui, 915-8586, Japan. 4. Department of Public Health and Home Nursing, Graduate School of Medical Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan. 5. Nippon Express Co., Inc. Toyama, 1-2-9 Takara-cho, Toyama, 930-0007, Japan. 6. Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan. 7. Fuji Memorial Institute of Medical Sciences, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan. 8. University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan.
Abstract
We found that community-dwelling women with 25-hydroxyvitamin D levels <20 ng/mL compared to levels ≥20 ng/mL indicated increased risks for clinical, non-vertebral, and fragility fractures during 5 years. Furthermore, the increased risks of non-vertebral fractures remained significant in 10 and 15 years after adjusting for age and bone mineral density. INTRODUCTION: We examined whether total 25-hydroxyvitamin D (25[OH]D) levels are associated with fracture risk over 15 years in a Japanese female cohort. METHODS: Of 1437 community-dwelling women aged ≥50 years in the baseline survey, 1236 provided information regarding fractures during a 15-year follow-up period. The analysis included 1211 women without early menopause or diseases affecting bone metabolism. RESULTS: Over 15 years, 269 clinical (224 non-vertebral, 149 fragility) fracture events were confirmed. Incidence rates categorized by 25(OH)D levels (<10, 10-20, 20-30, and ≥30 ng/mL) indicated a significant divergence for any clinical fractures in 5 years (log rank test p = 0.016) and for non-vertebral fractures in 5, 10, and 15 years (p < 0.001, p = 0.001, p = 0.017, respectively). Hazard ratios (HRs) for 25(OH)D levels <10 and 10-20 ng/mL compared to levels ≥30 ng/mL during 5 years indicated significances for clinical fractures (HR 4.93 with p = 0.009, HR 3.00 with p = 0.034) and for non-vertebral fractures (HR 6.55 with p = 0.005, HR 3.49 with p = 0.036). Those with levels <20 ng/mL compared to those with levels ≥20 ng/mL indicated significant increased risks for clinical fractures (HR 1.72 with p = 0.010), non-vertebral fractures (HR 2.45 with p < 0.001), and fragility fractures (HR 2.00 with p = 0.032) in 5 years. The HR of non-vertebral fractures for levels <20 ng/mL remained significant during 15 years (HR 1.42 with p = 0.012) after adjustment for age and femoral neck bone mineral density. CONCLUSIONS: Low 25(OH)D levels, especially <20 ng/mL, were associated with elevated fracture risks in Japanese women.
We found that community-dwelling women with 25-hydroxyvitamin D levels <20 ng/mL compared to levels ≥20 ng/mL indicated increased risks for clinical, non-vertebral, and fragility fractures during 5 years. Furthermore, the increased risks of non-vertebral fractures remained significant in 10 and 15 years after adjusting for age and bone mineral density. INTRODUCTION: We examined whether total 25-hydroxyvitamin D (25[OH]D) levels are associated with fracture risk over 15 years in a Japanese female cohort. METHODS: Of 1437 community-dwelling women aged ≥50 years in the baseline survey, 1236 provided information regarding fractures during a 15-year follow-up period. The analysis included 1211 women without early menopause or diseases affecting bone metabolism. RESULTS: Over 15 years, 269 clinical (224 non-vertebral, 149 fragility) fracture events were confirmed. Incidence rates categorized by 25(OH)D levels (<10, 10-20, 20-30, and ≥30 ng/mL) indicated a significant divergence for any clinical fractures in 5 years (log rank test p = 0.016) and for non-vertebral fractures in 5, 10, and 15 years (p < 0.001, p = 0.001, p = 0.017, respectively). Hazard ratios (HRs) for 25(OH)D levels <10 and 10-20 ng/mL compared to levels ≥30 ng/mL during 5 years indicated significances for clinical fractures (HR 4.93 with p = 0.009, HR 3.00 with p = 0.034) and for non-vertebral fractures (HR 6.55 with p = 0.005, HR 3.49 with p = 0.036). Those with levels <20 ng/mL compared to those with levels ≥20 ng/mL indicated significant increased risks for clinical fractures (HR 1.72 with p = 0.010), non-vertebral fractures (HR 2.45 with p < 0.001), and fragility fractures (HR 2.00 with p = 0.032) in 5 years. The HR of non-vertebral fractures for levels <20 ng/mL remained significant during 15 years (HR 1.42 with p = 0.012) after adjustment for age and femoral neck bone mineral density. CONCLUSIONS: Low 25(OH)D levels, especially <20 ng/mL, were associated with elevated fracture risks in Japanese women.
Entities:
Keywords:
25-Hydroxyvitamin D; Fracture; Japanese women; Prospective cohort study
Authors: Håkan Melhus; Greta Snellman; Rolf Gedeborg; Liisa Byberg; Lars Berglund; Hans Mallmin; Per Hellman; Rune Blomhoff; Emil Hagström; Johan Arnlöv; Karl Michaëlsson Journal: J Clin Endocrinol Metab Date: 2010-03-23 Impact factor: 5.958
Authors: Ramón A Durazo-Arvizu; Bess Dawson-Hughes; Christopher T Sempos; Elizabeth A Yetley; Anne C Looker; Guichan Cao; Susan S Harris; Vicki L Burt; Alicia L Carriquiry; Mary Frances Picciano Journal: J Nutr Date: 2010-01-20 Impact factor: 4.798
Authors: S R Nussbaum; R J Zahradnik; J R Lavigne; G L Brennan; K Nozawa-Ung; L Y Kim; H T Keutmann; C A Wang; J T Potts; G V Segre Journal: Clin Chem Date: 1987-08 Impact factor: 8.327
Authors: I Nurmi-Lüthje; R Tiihonen; E-L Paattiniemi; H Naboulsi; S Pigg; H Sarkkinen; J-P Kaukonen; A Toivanen; K Salmio; M Kataja; P Lüthje Journal: Osteoporos Int Date: 2017-12-19 Impact factor: 4.507