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Osteoporosis International

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01.06.2020 | Original Article

Effect of vitamin D on bone strength in older African Americans: a randomized controlled trial

verfasst von: R. Dhaliwal, S. Islam, M. Mikhail, L. Ragolia, J.F. Aloia

Erschienen in: Osteoporosis International | Ausgabe 6/2020

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Abstract

Summary

There is controversy over whether African Americans have higher vitamin D requirements than recommended by the Institute of Medicine. We previously reported that maintaining serum 25(OH)D above 30 ng/mL does not prevent age-related bone loss. Herein, we report that bone strength is also unaffected by maintaining this level in this population.

Introduction

The role of vitamin D in bone strength has not been investigated in the African American (AA) population.

Methods

A 3-year randomized controlled trial was designed to examine the effect of vitamin D supplementation on physical performance, bone loss, and bone strength in healthy older AA women. A total of 260 postmenopausal AA women, ages ≥ 60 years were randomized to a vitamin D₃ or placebo arm. Vitamin D₃ dose was adjusted to maintain serum 25OHD > 30 ng/mL. Bone mineral density, femoral axis length, and femoral neck (FN) width were measured by dual-energy X-ray absorptiometry. Composite indices of FN strength [compression strength index (CSI), bending strength index (BSI), and impact strength index (ISI)] were computed.

Results

The mean age of participants was 68.2 ± 4.9 years. Baseline characteristics between groups were similar. The average dose of vitamin D₃ was 3490 ± 1465 IU/day in the active group. The mean serum 25OHD was 46.8 ± 1.2 ng/mL versus 20.7 ± 1.1 ng/mL in the active versus placebo group. Serum 25OHD did not correlate with any composite indices. The longitudinal differences observed in FN width, CSI, BSI, and ISI in both groups were not statistically significant (all p values > 0.05). Further, there was no group × time interaction effect for any of the composite indices (all p values > 0.05).

Conclusion

Maintaining serum 25OHD > 30 ng/mL (75 nmol/L) does not affect bone strength in older AA women. There is no evidence to support vitamin D intake greater than the recommended RDA by the Institute of Medicine in this population for bone strength.

Fang J, Freeman R, Jeganathan R, Alderman MH (2004) Variations in hip fracture hospitalization rates among different race/ethnicity groups in New York City. Ethn Dis 14(2):280–284PubMed

Griffin MR, Ray WA, Fought RL, Melton LJ 3rd. (1992) Black-white differences in fracture rates. Am J Epidemiol 136(11):1378–1385PubMed

Karagas MR, Lu-Yao GL, Barrett JA, Beach ML, Baron JA (1996) Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Am J Epidemiol 143(7):677–682PubMed

Aloia JF (2008) African Americans, 25-hydroxyvitamin D, and osteoporosis: a paradox. Am J Clin Nutr 88(2):545S–550SPubMedPubMedCentral

Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF, Yetley EA (2008) Serum 25-hydroxyvitamin D status of the US population: 1988-1994 compared with 2000-2004. Am J Clin Nutr 88(6):1519–1527PubMedPubMedCentral

Nelson DA, Barondess DA, Hendrix SL, Beck TJ (2000) Cross-sectional geometry, bone strength, and bone mass in the proximal femur in black and white postmenopausal women. J Bone Miner Res 15(10):1992–1997PubMed

Nelson DA, Beck TJ, Wu G, Lewis CE, Bassford T, Cauley JA, LeBoff M, Going SB, Chen Z (2011) Ethnic differences in femur geometry in the women’s health initiative observational study. Osteoporos Int 22(5):1377–1388PubMed

Peacock M, Buckwalter KA, Persohn S, Hangartner TN, Econs MJ, Hui S (2009) Race and sex differences in bone mineral density and geometry at the femur. Bone 45(2):218–225PubMedPubMedCentral

Aloia JF, Talwar SA, Pollack S, Yeh J (2005) A randomized controlled trial of vitamin D3 supplementation in African American women. Arch Intern Med 165(14):1618–1623PubMedPubMedCentral

10.

Nieves JW, Cosman F, Grubert E, Ambrose B, Ralston SH, Lindsay R (2012) Skeletal effects of vitamin D supplementation in postmenopausal black women. Calcif Tissue Int 91(5):316–324PubMed

11.

Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC TC, Yaktine AL, Del Valle HB, editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US). 2011

12.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine Society (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930PubMed

13.

Heaney RP, Holick MF (2011) Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res 26(3):455–457PubMed

14.

Holick MF (2011) The D-batable Institute of Medicine report: a D-lightful perspective. Endocr Pract 17(1):143–149PubMed

15.

Dhaliwal R, Mikhail M, Usera G, Stolberg A, Islam S, Ragolia L, Aloia JF (2018) The relationship of physical performance and osteoporosis prevention with vitamin D in older African Americans (PODA). Contemp Clin Trials 65:39–45PubMed

16.

Aloia J, Fazzari M, Islam S, Mikhail M, Shieh A, Katumuluwa S, Dhaliwal R, Stolberg A, Usera G, Ragolia L (2018) Vitamin D supplementation in elderly black women does not prevent bone loss: a randomized controlled trial. J Bone Miner Res 33(11):1916–1922PubMed

17.

Allolio B (1999) Risk factors for hip fracture not related to bone mass and their therapeutic implications. Osteoporos Int 9(Suppl 2):S9–S16PubMed

18.

Alonso CG, Curiel MD, Carranza FH, Cano RP, Perez AD (2000) Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Multicenter project for research in osteoporosis. Osteoporos Int 11(8):714–720PubMed

19.

Heaney RP, Barger-Lux MJ, Davies KM, Ryan RA, Johnson ML, Gong G (1997) Bone dimensional change with age: interactions of genetic, hormonal, and body size variables. Osteoporos Int 7(5):426–431PubMed

20.

Beck TJ, Petit MA, Wu G, LeBoff MS, Cauley JA, Chen Z (2009) Does obesity really make the femur stronger? BMD, geometry, and fracture incidence in the women’s health initiative-observational study. J Bone Miner Res 24(8):1369–1379PubMedPubMedCentral

21.

Karlamangla AS, Barrett-Connor E, Young J, Greendale GA (2004) Hip fracture risk assessment using composite indices of femoral neck strength: the Rancho Bernardo study. Osteoporos Int 15(1):62–70PubMed

22.

Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L (2019) Vitamin D and falls in older African American women: the PODA randomized clinical trial. J Am Geriatr Soc 67(5):1043–1049PubMed

23.

Danielson ME, Beck TJ, Karlamangla AS, Greendale GA, Atkinson EJ, Lian Y, Khaled AS, Keaveny TM, Kopperdahl D, Ruppert K, Greenspan S, Vuga M, Cauley JA (2013) A comparison of DXA and CT based methods for estimating the strength of the femoral neck in post-menopausal women. Osteoporos Int 24(4):1379–1388PubMed

24.

Rubin DB (1976) Inference and missing data. Biometrika 63(3):581–592

25.

Ibrahim JG, Molenberghs G (2009) Missing data methods in longitudinal studies: a review. Test (Madr) 18(1):1–43

26.

Barrett-Connor E, Siris ES, Wehren LE, Miller PD, Abbott TA, Berger ML, Santora AC, Sherwood LM (2005) Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res 20(2):185–194PubMed

27.

Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Berger ML, Santora AC, Sherwood LM (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA. 286(22):2815–2822PubMed

28.

Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, Cummings SR (2008) Prediction of incident hip fracture risk by femur geometry variables measured by hip structural analysis in the study of osteoporotic fractures. J Bone Miner Res 23(12):1892–1904PubMedPubMedCentral

29.

Cummings SR, Cauley JA, Palermo L et al (1994) Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Study of Osteoporotic Fractures Research Group. Osteoporos Int 4(4):226–229PubMed

30.

Danielson ME, Beck TJ, Lian Y, Karlamangla AS, Greendale GA, Ruppert K, Lo J, Greenspan S, Vuga M, Cauley JA (2013) Ethnic variability in bone geometry as assessed by hip structure analysis: findings from the hip strength across the menopausal transition study. J Bone Miner Res 28(4):771–779PubMedPubMedCentral

31.

Mikhail MB, Vaswani AN, Aloia JF (1996) Racial differences in femoral dimensions and their relation to hip fracture. Osteoporos Int 6(1):22–24PubMed

32.

Ishii S, Cauley JA, Greendale GA, Danielson ME, Safaei Nili N, Karlamangla A (2012) Ethnic differences in composite indices of femoral neck strength. Osteoporos Int 23(4):1381–1390PubMed

33.

Hwang S, Choi HS, Kim KM, Rhee Y, Lim SK (2015) Associations between serum 25-hydroxyvitamin D and bone mineral density and proximal femur geometry in Koreans: the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2009. Osteoporos Int 26(1):163–171PubMed

34.

Jackson RD, Wright NC, Beck TJ, Sherrill D, Cauley JA, Lewis CE, LaCroix A, LeBoff M, Going S, Bassford T, Chen Z (2011) Calcium plus vitamin D supplementation has limited effects on femoral geometric strength in older postmenopausal women: the Women’s Health Initiative. Calcif Tissue Int 88(3):198–208PubMedPubMedCentral

35.

Martin EN, Haney EM, Shannon J, Cauley JA, Ensrud KE, Keaveny TM, Zmuda JM, Orwoll ES, Harrison SL, Marshall LM (2015) Femoral volumetric bone density, geometry, and strength in relation to 25-hydroxy vitamin D in older men. J Bone Miner Res 30(3):562–569PubMed

36.

Dhaliwal R, Aloia JF (2017) Effect of vitamin D on falls and physical performance. Endocrinol Metab Clin N Am 46(4):919–933

37.

Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, Staehelin HB, Meyer OW, Theiler R, Dick W, Willett WC, Egli A (2016) Monthly high-dose vitamin D treatment for the prevention of functional decline: a randomized clinical trial. JAMA Intern Med 176(2):175–183PubMed

38.

Cauley JA, Danielson ME, Boudreau R et al (2011) Serum 25-hydroxyvitamin D and clinical fracture risk in a multiethnic cohort of women: the Women’s Health Initiative (WHI). J Bone Miner Res 26(10):2378–2388PubMedPubMedCentral

39.

Faulkner KA, Cauley JA, Zmuda JM, Landsittel DP, Newman AB, Studenski SA, Redfern MS, Ensrud KE, Fink HA, Lane NE, Nevitt MC (2006) Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women. Osteoporos Int 17(9):1318–1328PubMed

40.

Beaudart C, Buckinx F, Rabenda V, Gillain S, Cavalier E, Slomian J, Petermans J, Reginster JY, Bruyère O (2014) The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 99(11):4336–4345PubMed

41.

Aloia JF, Vaswani A, Ma R, Flaster E (1996) Body composition in normal black women: the four-compartment model. J Clin Endocrinol Metab 81(6):2363–2369PubMed

42.

Kritchevsky SB, Tooze JA, Neiberg RH, Schwartz GG, Hausman DB, Johnson MA, Bauer DC, Cauley JA, Shea MK, Cawthon PM, Harris TB, Rubin SM, Tylavsky FA, Houston DK, Health ABC Study (2012) 25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults: the health ABC study. J Clin Endocrinol Metab 97(11):4156–4165PubMedPubMedCentral

43.

Cauley JA, Lui LY, Stone KL, Hillier TA, Zmuda JM, Hochberg M, Beck TJ, Ensrud KE (2005) Longitudinal study of changes in hip bone mineral density in Caucasian and African-American women. J Am Geriatr Soc 53(2):183–189PubMed

44.

Manson JE, Cook NR, Lee IM et al (2019) Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med 380(1):33–44PubMed

45.

Urashima M, Ohdaira H, Akutsu T et al (2019) Effect of vitamin D supplementation on relapse-free survival among patients with digestive tract cancers: the AMATERASU randomized clinical trial. JAMA 321(14):1361–1369PubMedPubMedCentral

Titel: Effect of vitamin D on bone strength in older African Americans: a randomized controlled trial
verfasst von: R. Dhaliwal
S. Islam
M. Mikhail
L. Ragolia
J.F. Aloia
Publikationsdatum: 01.06.2020
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 6/2020
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-019-05275-1

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