Bess Dawson-Hughes1, Jifan Wang1, Kathryn Barger1, Heike A Bischoff-Ferrari2, Christopher T Sempos3, Ramon A Durazo-Arvizu4, Lisa Ceglia1,5. 1. Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA. 2. Department of Aging Medicine and Aging Research, University of Zurich, and City Hospital Zurich-Waid, Zurich, Switzerland. 3. Vitamin D Standardization Program (VDSP), Havre de Grace, MD, USA. 4. The Saban Research Institute at Children's Hospital Los Angeles, Los Angeles, CA, USA. 5. Division of Endocrinology, Tufts Medical Center, Boston MA, USA.
Abstract
CONTEXT: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. OBJECTIVE: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in healthy older adults. DESIGN: Observational within a clinical trial. SETTING: The Bone Metabolism Laboratory at the USDA Nutrition Center at Tufts University. PARTICIPANTS: 410 men and women age ≥65 years who participated in the 3-year Boston STOP IT trial to determine the effect of supplementation with 700 IU of vitamin D3 plus calcium on incident falls (secondary endpoint). Intra-trial exposures of 25(OH)D and PTH were calculated as the mean of biannual measures up to and including the first fall. MAIN OUTCOME MEASURES: Incidence of first fall. RESULTS: Intra-trial mean 25(OH)D was significantly associated with risk of falling in a U-shaped pattern; the range associated with minimal risk of falling was approximately 20 to 40 ng/mL. PTH was not significantly associated with risk of falling. CONCLUSIONS: The findings highlight the importance of maintaining the circulating 25(OH)D level between 20 and 40 ng/mL, the range that is also recommended for bone health. At PTH levels within the normal range, there was no detectible independent association of PTH with fall risk.
CONTEXT: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. OBJECTIVE: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in healthy older adults. DESIGN: Observational within a clinical trial. SETTING: The Bone Metabolism Laboratory at the USDA Nutrition Center at Tufts University. PARTICIPANTS: 410 men and women age ≥65 years who participated in the 3-year Boston STOP IT trial to determine the effect of supplementation with 700 IU of vitamin D3 plus calcium on incident falls (secondary endpoint). Intra-trial exposures of 25(OH)D and PTH were calculated as the mean of biannual measures up to and including the first fall. MAIN OUTCOME MEASURES: Incidence of first fall. RESULTS: Intra-trial mean 25(OH)D was significantly associated with risk of falling in a U-shaped pattern; the range associated with minimal risk of falling was approximately 20 to 40 ng/mL. PTH was not significantly associated with risk of falling. CONCLUSIONS: The findings highlight the importance of maintaining the circulating 25(OH)D level between 20 and 40 ng/mL, the range that is also recommended for bone health. At PTH levels within the normal range, there was no detectible independent association of PTH with fall risk.
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
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