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Vitamin D supplementation benefits middle-aged women with low 25-(OH)D levels
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Middle-aged women with serum 25-hydroxyvitamin D levels less than 20 ng/mL should use vitamin D supplementation, according to study findings published in The Journal of Clinical Endocrinology & Metabolism.
An inverse association was found between nontraumatic fractures in middle-aged women and serum 25-(OH)D levels.
Jane A. Cauley, DrPH, of the University of Pittsburgh, and colleagues conducted a prospective cohort study at five U.S. clinical centers on women aged 42 to 52 years (mean age, 48.5 years) to determine whether slower loss of bone mineral density and lower fracture risk during the menopausal transition are associated with higher 25-(OH)D levels. For the fracture analysis, researchers studied data from 124 women with an incident fracture, 88 with incident nontraumatic fracture and 1,532 without incident fractures; 922 women with a documented final menstrual period were evaluated for the BMD analysis.
White participants had the highest 25-(OH)D levels, black participants had the lowest, and Chinese and Japanese participants had intermediate levels; mean 25-(OH)D level was 21.8 ng/mL. Forty-three percent of participants had 25-(OH)D levels less than 20 ng/mL and 80% had levels of at least 30 ng/mL.
Seven percent of participants experienced an incident traumatic fracture, and 5.4% experienced an incident nontraumatic fracture during an average of 9.5 years. Traumatic factures were experienced by more white participants (8.9%) compared with Chinese participants (7.4%), black participants (5.2%) and Japanese participants (3.3%). Similarly, nontraumatic fractures were experienced by more white participants (5.9%) compared with black participants (5.45%), Japanese participants (3.75%) and Chinese participants (2.3%). Leg, hand/wrist and foot/ankle were the most commonly reported traumatic and nontraumatic fractures.
No association was found between 25-(OH)D levels and traumatic fractures, and women with levels of at least 20 ng/mL had a similar risk for fracture as those with lower levels.
Participants with 25-(OH)D levels of at least 20 ng/mL had lower risks for nontraumatic fracture (P = .08); the HR was 0.72 for every 10 ng/mL increased in levels. The HR for fracture was 0.54 when comparing participants with serum levels of at least 20 ng/mL vs. less than 20 ng/mL.
“In conclusion, women with higher (≥ 20 ng/mL) serum 25-(OH)D at midlife have a lower risk of nontraumatic fractures across the [menopausal transition]. … This association was independent of BMD, BMI and other risk factors for fracture. There was no association between 25-(OH)D and traumatic fractures or with changes in BMD across the [menopausal transition]. The lack of an association with transmenopausal bone loss suggests that other factors, eg, muscle strength, may contribute to the lower fracture risk with increasing 25-(OH)D. Women with 25-(OH)D (< 20 ng/mL) compared with women with vitamin D levels of 20 ng mL or more were less likely to report vitamin D supplements (13% and 24%, respectively). Because few foods contain vitamin D, our results suggest that vitamin D supplementation is warranted in women at midlife with 25-(OH)D less than 20 ng/mL.” – by Amber Cox
Disclosure: Cauley reports no relevant financial disclosures. See the full study for a complete list of all other authors’ relevant financial disclosures.
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