Funded in part by Amgen, Pfizer, GlaxoSmithKline, Sanofi, Servier, Allergan
Serum 25-Hydroxyvitamin D Insufficiency in Search of a Bone Disease
Shah S, Chiang C, Sikaris K, Lu Z, Bui M, Zebaze R, Seeman E
The Journal of clinical endocrinology and metabolism · 46 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Industry funded
- Company
- Amgen
- Company
- Pfizer
- Company
- GlaxoSmithKline
- Company
- Sanofi
- Company
- Servier
- Company
- Allergan
Based on 6 listed funder(s).
Publication
- Published
- 2017-03-30 · J Clin Endocrinol Metab · vol. 102 · issue 7 · pp. 2321–2328
- Publisher
- Oxford University Press
- Cited
- 49 citations · more than 94% of similar papers · 3.8× the field average
- Impact
- Top 10% most cited in its field
- References
- 19 works
- Access
- Free to read
- Research areas
- Vitamin D Research Studies · Parathyroid Disorders and Treatments · Bone health and osteoporosis research
- Keywords
- Internal medicine, Endocrinology, N-terminal telopeptide, Parathyroid hormone, Bone remodeling, Vitamin D and neurology, vitamin D deficiency, Bone mineral, Osteoporosis, Hyperparathyroidism, Alkaline phosphatase, Hypophosphatemia, Bone resorption, Bone density, Calcium, Medicine, Secondary hyperparathyroidism, Chemistry, Osteocalcin, Biochemistry
- MeSH
- humans, bone diseases, vitamin d deficiency, phosphates, calcium, parathyroid hormone, alkaline phosphatase, vitamin d, glomerular filtration rate, cohort studies, bone remodeling, bone density, adult, aged, middle aged, victoria, female, male
7 authors
From AU
- Sonali S. ShahAustin Health
- Cherie Ying ChiangAustin Health
- Ken A. SikarisMelbourne Clinic; Melbourne Health
- Zhong Xian LuMelbourne Clinic; Melbourne Health
- Minh BuiThe University of Melbourne
- Roger Martin Djoumessi ZebazeAustin Health
Abstract
Context
Vitamin D "insufficiency" and "deficiency" are defined as serum 25-hydroxyvitamin D [25(OH)D] levels <75 and <30 nmol/L, respectively. We aimed to determine whether these values signal hypocalcemia and hypophosphatemia, secondary hyperparathyroidism, high bone remodeling, low areal bone mineral density (aBMD), microstructural deterioration, or reduced matrix mineralization density (MMD) and so suggest whether bone fragility is present.
Methods
Concentrations of 25(OH)D, calcium, phosphate, creatinine, and parathyroid hormone (PTH) were measured in 11,855 participants. Serum C-terminal telopeptide of type 1 collagen, procollagen type 1 N-terminal propeptide (P1NP), aBMD, and distal radius microstructure and MMD were measured in a second subset of 150 participants.
Results
A breakpoint for calcium, PTH, and alkaline phosphatase was identified at a threshold 25(OH)D level <30 nmol/L. There was no plateau beyond 75 nmol/L. In the subgroup with measurements of bone morphology, no associations were detectable between serum 25(OH)D concentration, aBMD, trabecular density, cortical porosity, or MMD. Among 1439 participants with serum 25(OH)D <30 nmol/L, 6.1% had low serum calcium, 3.4% had low serum phosphate, 6.1% had high alkaline phosphatase, and 34.2% had elevated PTH. Most participants did not have any abnormalities.
Conclusion
At a 25(OH)D threshold of ≤30 nmol/L, abnormalities in biochemical features support the notion of a "deficiency" state predisposing to bone disease. However, no deleterious effects were found in participants within an insufficiency threshold of a 25(OH)D level of 30 to 75 nmol/L, which challenges the rationale justifying vitamin D supplementation in these individuals.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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