Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis

• Published in: Osteoporosis international Vol. 28; no. 4; pp. 1377 - 1384
• Main Authors: Lee, D. Y., Jee, J. H., Cho, Y. Y., Jang, J. Y., Yu, T. Y., Kim, T. H., Hong, Y. J., Hong, W.-J., Jin, S.-M., Hur, K. Y., Kim, J. H., Kim, S. W., Chung, J. H., Lee, M. K., Min, Y.-K.
• Format: Journal Article
• Language: English
• Published: London Springer London 01-04-2017; Springer Nature B.V
• Subjects: 25-Hydroxyvitamin D; Aged; Alkaline phosphatase; Biochemical markers; Biomarkers - blood; Bone Density - physiology; Bone mass; Bone mineral density; Bone Remodeling - physiology; Bone turnover; Chromatography, Liquid - methods; Collagen; Cross-linking; Densitometry; Endocrinology; Female; Femur; Femur - physiopathology; Femur Neck - physiopathology; Humans; Liquid chromatography; Mass spectroscopy; Medical records; Medicine; Medicine & Public Health; Middle Aged; Neck; Original Article; Orthopedics; Osteopenia; Osteoporosis; Osteoporosis, Postmenopausal - blood; Osteoporosis, Postmenopausal - etiology; Osteoporosis, Postmenopausal - physiopathology; Parathyroid hormone; Parathyroid Hormone - blood; Post-menopause; Rheumatology; Studies; Tandem Mass Spectrometry - methods; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; Vitamin D Deficiency - physiopathology; Bone mineral density; Biochemical markers of bone turnover; 25-hydroxyvitamin D; Vitamin D insufficiency; Parathyroid hormone
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-016-3892-0

Summary
This study sought to determine the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health in postmenopausal women with low bone mass. A serum 25(OH)D concentration of 20 ng/mL rather than 30 ng/mL was appropriate for bone health.
Introduction
There is no consensus on the minimal serum 25-hydroxyvitamin D [25(OH)D] concentration required to maintain bone health. The aim of this study was to investigate the relationship between 25(OH)D measured via liquid chromatography-mass spectrometry (LC–MS/MS), which is the current gold standard, and biochemical markers of bone turnover, PTH, and bone mineral densitometry (BMD).
Methods
The medical records of 750 postmenopausal women newly diagnosed with osteoporosis or osteopenia at Samsung Medical Center from 2009 to 2014 were investigated. Subjects were divided into four groups according to serum 25(OH)D concentration: <10, 10–20, 20–30, and ≥30 ng/mL. Serum concentrations of bone-specific alkaline phosphatase (BS-ALP), carboxy-terminal cross-linking telopeptide of type 1 collagen (CTx), intact PTH (iPTH), and BMD were compared among the four groups using analysis of covariance. Thresholds of 25(OH)D were then assessed using spline plots and locally weighted regression smoothing (LOESS) plots.
Results
25(OH)D was negatively correlated with serum BS-ALP, CTx, and iPTH. Only femur neck and total femur BMD had significant positive relationships with 25(OH)D. Cutoff values of 11.9 and 9.7 ng/mL were estimated from the spline plots of femur neck and total femur BMD, respectively. For iPTH, the LOESS plot showed a steep decrease to a serum 25(OH)D concentration of about 20 ng/mL, followed by a plateau.
Conclusions
According to this study, a serum 25(OH)D concentration of 20 ng/mL, rather than 30 ng/mL, was appropriate for bone health.