Vitamin D Status, Including Serum Levels and Sun Exposure Are Associated or Correlated with Bone Mass Measurements Diagnosis, and Bone Density of the Spine

Overview

Journal BMC Nutr

Publisher Biomed Central

Specialty Nutritional Sciences

Date 2023 Mar 15

PMID 36918953

Authors

Adeleh Khodabakhshi

Sayed Hossein Davoodi

Farhad Vahid

Affiliations

Soon will be listed here.

Abstract

Background: Osteoporosis is a health complication worldwide, especially in developing countries. The prevalence was reported to be 18.3% globally. While the effect of biochemical factors on fracture risk/odds has been documented, the association/correlation between serum 25(OH)D levels, vitamin D dietary intake, and sun exposure with bone mineral density (BMD) remains controversial. This study aimed to evaluate the association and correlation between vitamin D status, including serum levels, dietary intakes, and sun exposure with BMD. We hypothesized that vitamin D-related factors would have different correlations/associations with BMD, which would help better evaluate future studies' results.

Methods: A total of 186 individuals were included in this study (winter 2020). BMD was measured by Dual-energy X-ray absorptiometry. Blood serum levels of 25(OH)D, phosphorus, calcium, parathyroid hormone (PTH), and calcitonin were tested using standard lab tests. Valid and reliable questionnaires were used for sun exposure assessment and dietary intakes.

Results: There was a significant protective association between spine BMD (classifications, two groups) (OR = 0.69, 95%CI: 0.50-0.94; p-value = 0.023), BMD diagnosis (classifications, two groups) (OR = 0. 69, 95%CI: 0.49-0.87; p-value = 0.036) and sun exposure. There was a significant and moderate correlation between Spine measurements (Spine BMD: Pearson correlation coefficient = 0.302, p-value = 0.046; Spine T-score: Pearson correlation coefficient = 0.322, p-value = 0.033, Spine Z-score: Pearson correlation coefficient = 0.328, p-value = 0.030) and serum 25(OH)D. In addition, participants with osteopenia and osteoporosis significantly consume a higher amount of soluble fiber than the normal BMD group. There was no significant correlation between vitamin D intake and BMD.

Conclusion: In conclusion, serum 25(OH)D levels and sun exposure are correlated and associated with BMD. However, prospective studies are needed to investigate the association between dietary vitamin D intake and BMD.

Citing Articles

Maternal Diet Associates with Offspring Bone Mineralization, Fracture Risk and Enamel Defects in Childhood and Influences the Prenatal Effect of High-Dose Vitamin D Supplementation.

Kim M, Norrisgaard P, Vahman N, Cexus O, Townsend P, Stokholm J Nutrients. 2024; 16(3).

PMID: 38337692 PMC: 10856831. DOI: 10.3390/nu16030405.

References

Bischoff-Ferrari H, Willett W, Wong J, Giovannucci E, Dietrich T, Dawson-Hughes B . Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005; 293(18):2257-64. DOI: 10.1001/jama.293.18.2257. View

Asghari G, Rezazadeh A, Hosseini-Esfahani F, Mehrabi Y, Mirmiran P, Azizi F . Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran Lipid and Glucose Study. Br J Nutr. 2012; 108(6):1109-17. DOI: 10.1017/S0007114511006313. View

Chhantyal K, He L, Mo J, Yin M, He T, Chen Y . Free vitamin D correlate better with bone mineral density and thoracolumbar junction osteoporotic vertebral fractures than serum vitamin D. BMC Musculoskelet Disord. 2020; 21(1):164. PMC: 7069188. DOI: 10.1186/s12891-020-3179-7. View

Kamineni V, Latha A, Ramathulasi K . Association between serum 25-hydroxyvitamin D levels and bone mineral density in normal postmenopausal women. J Midlife Health. 2017; 7(4):163-168. PMC: 5192985. DOI: 10.4103/0976-7800.195694. View

Mahdavi S, Mansourian M, Shams E, Qorbani M, Heshmat R, Motlagh M . Association of Sunlight Exposure with Sleep Hours in Iranian Children and Adolescents: The CASPIAN-V Study. J Trop Pediatr. 2019; 66(1):4-14. DOI: 10.1093/tropej/fmz023. View

CHAPUY M, Arlot M, Delmas P, Meunier P . Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ. 1994; 308(6936):1081-2. PMC: 2539939. DOI: 10.1136/bmj.308.6936.1081. View

Jackson R, LaCroix A, Gass M, Wallace R, Robbins J, Lewis C . Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006; 354(7):669-83. DOI: 10.1056/NEJMoa055218. View

Sakuma M, Endo N, Oinuma T . Serum 25-OHD insufficiency as a risk factor for hip fracture. J Bone Miner Metab. 2007; 25(3):147-50. DOI: 10.1007/s00774-007-0749-9. View

Salari N, Ghasemi H, Mohammadi L, Behzadi M, Rabieenia E, Shohaimi S . The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2021; 16(1):609. PMC: 8522202. DOI: 10.1186/s13018-021-02772-0. View

10.

Alkhenizan A, Mahmoud A, Hussain A, Gabr A, Alsoghayer S, Eldali A . The Relationship between 25 (OH) D Levels (Vitamin D) and Bone Mineral Density (BMD) in a Saudi Population in a Community-Based Setting. PLoS One. 2017; 12(1):e0169122. PMC: 5207714. DOI: 10.1371/journal.pone.0169122. View

11.

Ardawi M, Maimany A, Bahksh T, Nasrat H, Milaat W, Al-Raddadi R . Bone mineral density of the spine and femur in healthy Saudis. Osteoporos Int. 2004; 16(1):43-55. DOI: 10.1007/s00198-004-1639-9. View

12.

Min C, Yoo D, Choi H . Associations between Physical Activity, Sunshine Duration and Osteoporosis According to Obesity and Other Lifestyle Factors: A Nested Case-Control Study. Int J Environ Res Public Health. 2021; 18(9). PMC: 8122401. DOI: 10.3390/ijerph18094437. View

13.

Choi S, Kweon S, Choi J, Rhee J, Lee Y, Nam H . The association between vitamin D and parathyroid hormone and bone mineral density: the Dong-gu Study. J Bone Miner Metab. 2015; 34(5):555-63. DOI: 10.1007/s00774-015-0696-9. View

14.

Lu Y, Genant H, Shepherd J, Zhao S, Mathur A, Fuerst T . Classification of osteoporosis based on bone mineral densities. J Bone Miner Res. 2001; 16(5):901-10. DOI: 10.1359/jbmr.2001.16.5.901. View

15.

Bruno A, Burkhart K, Allaire B, Anderson D, Bouxsein M . Spinal Loading Patterns From Biomechanical Modeling Explain the High Incidence of Vertebral Fractures in the Thoracolumbar Region. J Bone Miner Res. 2017; 32(6):1282-1290. PMC: 5466490. DOI: 10.1002/jbmr.3113. View

16.

Grant A, Avenell A, Campbell M, McDonald A, MacLennan G, McPherson G . Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet. 2005; 365(9471):1621-8. DOI: 10.1016/S0140-6736(05)63013-9. View

17.

LeBoff M, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J . Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA. 1999; 281(16):1505-11. DOI: 10.1001/jama.281.16.1505. View

18.

Pourhashem Z, Bayani M, Noreddini H, Bijani A, Hosseini S . Prevalence of osteoporosis and its association with serum vitamin D level in older people in Amirkola, North of Iran. Caspian J Intern Med. 2015; 3(1):347-53. PMC: 4600130. View

19.

Maier G, Seeger J, Horas K, Roth K, Kurth A, Maus U . The prevalence of vitamin D deficiency in patients with vertebral fragility fractures. Bone Joint J. 2015; 97-B(1):89-93. DOI: 10.1302/0301-620X.97B1.34558. View

20.

Khodabakhshi A, Mahmoudabadi M, Vahid F . The role of serum 25 (OH) vitamin D level in the correlation between lipid profile, body mass index (BMI), and blood pressure. Clin Nutr ESPEN. 2022; 48:421-426. DOI: 10.1016/j.clnesp.2022.01.007. View