Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men
Open Access
- 27 January 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Bone and Mineral Research
- Vol. 25 (3), 545-553
- https://doi.org/10.1359/jbmr.090826
Abstract
The association between vitamin D levels and incident fractures in older men is uncertain. To test the hypothesis that low serum 25‐hydroxyvitamin D [(25(OH)D] levels are associated with an increased risk of fracture, we performed a case‐cohort study of 436 men with incident nonspine fractures, including 81 hip fractures, and a random subcohort of 1608 men; average follow‐up time 5.3 years. Serum vitamin D2 and vitamin D3 were measured on baseline sera using mass spectrometry and summed for total vitamin D. Modified Cox proportional hazards models were used to estimate the hazard ratio (HR) of fracture with 95% confidence intervals (CIs). Multivariable models included age, clinic, season, race, height, weight, and physical activity. The mean (SD) total 25(OH)D was 24.6 (7.8) ng/mL in nonspine fracture subjects, 21.5 (7.9) ng/mL in hip fracture subjects, and 25.2 (7.8) ng/mL in controls (nonspine fracture subjects versus nonpatients, p = .14; hip fracture subjects versus controls, p < .0001). 25(OH)D levels were unrelated to nonspine fractures. One SD decrease in total 25(OH)D was associated with an increased risk of hip fracture (multivariate HR = 1.60; 95% CI 1.18–2.17). Compared with men in the top quartile of total 25(OH)D (≥28), the HR of hip fracture was 2.36 (95% CI 1.08–5.15) for men in the lowest quartile (p = .009 for trend). Adjusting for hip bone mineral density attenuated the association by more than 50% (p = .065 for trend). Low serum 25(OH)D concentrations are associated with a higher risk of hip fracture in older men. Measurement of 25(OH)D may be useful in identifying men at high risk of hip fracture. © 2010 American Society for Bone and Mineral Research.Keywords
This publication has 36 references indexed in Scilit:
- Vitamin D Deficiency in Older MenJournal of Clinical Endocrinology & Metabolism, 2009
- Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin DBone, 2008
- Serum 25-Hydroxyvitamin D and Hip Fracture Risk in Older U.S. White AdultsJournal of Bone and Mineral Research, 2008
- Association between Plasma 25-Hydroxyvitamin D Levels and Fracture Risk: The EPIC-Oxford StudyAmerican Journal of Epidemiology, 2007
- Vitamin D DeficiencyThe New England Journal of Medicine, 2007
- Calcium plus Vitamin D Supplementation and the Risk of FracturesThe New England Journal of Medicine, 2006
- Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study — A large observational study of the determinants of fracture in older menContemporary Clinical Trials, 2005
- Effect of Vitamin D on FallsJAMA, 2004
- BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long-Term Results From the Study of Osteoporotic FracturesJournal of Bone and Mineral Research, 2003
- Accuracy of the Jamar DynamometerJournal of Hand Therapy, 1993