F P Paranhos-Neto1, L Vieira Neto1, M Madeira1, A B Moraes1, L M C Mendonça2, I C B Lima3, C L R Chagas4, D A Lira4, J F Spitz4, J A M Guimarães4, M E L Duarte4, M L F Farias1. 1. Division of Endocrinology, Clementino Fraga Filho University Hospital, UFRJ, Rio de Janeiro, Rio de Janeiro, Brasil. 2. Division of Reumathology, Clementino Fraga Filho University Hospital, UFRJ, Rio de Janeiro, Rio de Janeiro, Brasil. 3. Program of Nuclear Engineering - COPPE - UFRJ, Rio de Janeiro, Rio de Janeiro, Brasil. 4. Research Division, National Institute of Orthopedics and Traumatology, Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract
INTRODUCTION: The role of vitamin D on bone microarchitecture and fragility is not clear. OBJECTIVE: To investigate whether vitamin D deficiency (25(OH)D <20 ng/mL) increases cortical bone loss and the severity of fractures. DESIGN: Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture. METHODS: Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high-resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure. RESULTS: Serum 25(OH)D levels were associated with body mass index (BMI: r = -0.161, P = 0.006), PTH (r = -0.165; P = 0.005), CTX (r = -0.119; P = 0.043) and vBMD at cortical bone (Dcomp: r = 0.132; P = 0.033) and entire bone (D100: r = 0.162 P = 0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI: 0.11-4.16; P < 0.01), 25(OH)D (95% CI: -0.007 to 1.70; P = 0.05) and CTX (95% CI: -149.04 to 21.80; P < 0.01) predicted Dcomp, while BMI (95% CI: 1.13-4.18; P < 0.01) and 25(OH)D (95% CI: 0.24-1.52; P < 0.01) predicted D100. NonVFs predominated in patients with 25(OH)D <20 ng/mL (P = 0.013). Logistic regression analysis showed a decrease in the likelihood of presenting grade 2-3 VFs/NonVFs for every increase in 25(OH)D (OR = 0.962, 95% CI: 0.940-0.984; P = 0.001), BMI (OR = 0.932, 95% CI: 0.885-0.981; P = 0.007) and D100 at radius (OR = 0.994, 95% CI: 0.990-0.998; P = 0.005). CONCLUSION: In elderly patients with prevalent fractures, vitamin D deficiency was associated with cortical bone loss and severity of fractures.
INTRODUCTION: The role of vitamin D on bone microarchitecture and fragility is not clear. OBJECTIVE: To investigate whether vitamin D deficiency (25(OH)D <20 ng/mL) increases cortical bone loss and the severity of fractures. DESIGN: Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture. METHODS: Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high-resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure. RESULTS: Serum 25(OH)D levels were associated with body mass index (BMI: r = -0.161, P = 0.006), PTH (r = -0.165; P = 0.005), CTX (r = -0.119; P = 0.043) and vBMD at cortical bone (Dcomp: r = 0.132; P = 0.033) and entire bone (D100: r = 0.162 P = 0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI: 0.11-4.16; P < 0.01), 25(OH)D (95% CI: -0.007 to 1.70; P = 0.05) and CTX (95% CI: -149.04 to 21.80; P < 0.01) predicted Dcomp, while BMI (95% CI: 1.13-4.18; P < 0.01) and 25(OH)D (95% CI: 0.24-1.52; P < 0.01) predicted D100. NonVFs predominated in patients with 25(OH)D <20 ng/mL (P = 0.013). Logistic regression analysis showed a decrease in the likelihood of presenting grade 2-3 VFs/NonVFs for every increase in 25(OH)D (OR = 0.962, 95% CI: 0.940-0.984; P = 0.001), BMI (OR = 0.932, 95% CI: 0.885-0.981; P = 0.007) and D100 at radius (OR = 0.994, 95% CI: 0.990-0.998; P = 0.005). CONCLUSION: In elderly patients with prevalent fractures, vitamin D deficiency was associated with cortical bone loss and severity of fractures.
Authors: Margaret Garrahan; Sarah Gehman; Sara E Rudolph; Adam S Tenforde; Kathryn E Ackerman; Kristin L Popp; Mary L Bouxsein; Shivani Sahni Journal: J Clin Endocrinol Metab Date: 2022-08-18 Impact factor: 6.134
Authors: Umberto Tarantino; Ida Cariati; Virginia Tancredi; Donato Casamassima; Eleonora Piccirilli; Riccardo Iundusi; Elena Gasbarra Journal: Int J Environ Res Public Health Date: 2020-10-22 Impact factor: 3.390