Document Detail

Hypovitaminosis D osteopathy: is it mediated through PTH, lean mass, or is it a direct effect?
MedLine Citation:
PMID:  16495164     Owner:  NLM     Status:  MEDLINE    
Hypovitaminosis D is increasing worldwide and is associated with low bone mass. The effects of hypovitaminosis D on bone might be direct or mediated through decreased muscle mass and function and/or secondary hyperparathyroidism. This study systematically investigated the relative contribution of lean mass, PTH, and the direct effect of vitamin D as predictors of vitamin D mediated osteopathy in elderly individuals. 460 ambulatory subjects aged 65-85 years had their bone mass and lean body mass measured by a dual-energy X-ray absorptiometry. Serum calcium, phosphorus and alkaline phosphatase, intact parathyroid hormone (PTH) and 25-hydroxyvitamin D (25 OHD) were also measured. Serum 25 OHD correlated with lean body mass in men, r = 0.24, P = 0.002, but not in women; and with bone mass at all skeletal sites in men, r = 0.20-0.30, P < 0.02. Correlations were also noted at all skeletal sites in women except for the spine, r = 0.13-0.18, P < 0.04. In both genders, BMD at sites enriched in cortical bone was 0.4-0.7 SD lower in the group with the lowest vitamin D tertile than that in the group in the highest tertile. After controlling for PTH, the magnitude of the correlations between BMD and 25 OHD remained significant in both genders. After controlling for lean body mass, the magnitude of these correlations did not change in women and decreased but remained significant in men. After adjustment for age and height, both lean body mass and PTH had significant independent contributions to BMD variance at all skeletal sites. After adjustment for age, height, lean mass, and PTH, 25 OHD did not have any significant residual contribution to BMD variance except at the trochanter in men. This study demonstrates that vitamin D osteopathy in the elderly is in large part mediated through lean mass in men and through PTH levels in both genders, with a greater contribution of PTH in women than in men. There was little demonstrable independent relation between serum 25 OHD and bone mass.
Asma Arabi; Rafic Baddoura; Hassane Awada; Mariana Salamoun; Ghazi Ayoub; Ghada El-Hajj Fuleihan
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-21
Journal Detail:
Title:  Bone     Volume:  39     ISSN:  8756-3282     ISO Abbreviation:  Bone     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-06-16     Completed Date:  2006-08-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8504048     Medline TA:  Bone     Country:  United States    
Other Details:
Languages:  eng     Pagination:  268-75     Citation Subset:  IM    
Calcium Metabolism and Osteoporosis Program, American University of Beirut-Medical Center, Bliss street, Beirut 113-6044, Lebanon.
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MeSH Terms
Absorptiometry, Photon
Aged, 80 and over
Alkaline Phosphatase / blood
Body Composition
Bone Density
Calcium / blood
Femur / metabolism,  pathology,  radiography
Linear Models
Parathyroid Hormone / blood,  metabolism*
Retrospective Studies
Rickets / etiology*,  metabolism*,  pathology,  radiography
Sex Factors
Thinness / metabolism*,  radiography
Urban Population
Vitamin D / analogs & derivatives,  blood
Vitamin D Deficiency / metabolism*,  radiography
Reg. No./Substance:
0/PTH protein, human; 0/Parathyroid Hormone; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D; 7440-70-2/Calcium; EC Phosphatase

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