Vitamin D and bone quality

Overview

Introduction: The contribution of vitamin D to the reduction of fractures can be attributed, at least in part, to a beneficial effect on BMD, but also to an effect on bone microstructure. There is little evidence to explain the effect of vitamin D on bone microarchitecture. Objective: To assess the relationship between 25(OH)D3 levels and quantitative / qualitative bone parameters in postmenopausal women. Methods: A cross-sectional analysis of the effect of vitamin D levels on bone quality in postmenopausal women from endocrinology clinics undergoing DXA examination during 10/2015 to 03/2017, measured by BMD and TBS, was performed. Levels of 25 (OH) D3 were determined by chromatography using an HPLC system with UV detection (Chromsystem^®; interassay variability CV: 0.8–3.0 %). A total of 129 patients were included in the final analysis. They were divided into two groups according to the serum concentration of vitamin D, the level of 30 ng/ml was considered as the cut-off value. Results: The prevalence of vitamin D deficiency was more than 49,6 %. When comparing bone parameters between the two groups, we confirmed in the group with sufficient vitamin D levels a significantly higher number of patients (35 vs 55; p = 0.05) with prescribed vitamin D preparation and at the same time higher TBS values (1,241 vs 1,276; p = 0.05). BMD and bone turnover markers did not differ significantly. BMD in the total hip area was significantly lower in the group with sufficient vitamin D levels compared to the group with insufficient vitamin D levels. Conclusion: Vitamin D affects bone metabolism and at the same time positively affects bone quality. Optimal vitamin D levels contribute to good bone structure.

Keywords:

BMD – calcium – DXA – HR-pQCT – TBS – vitamin D