Introduction
Methods
Study Design
Vitamin D Groups
Assessment of Variables
Statistical Analysis
Results
Bone Mineral Density, Parameters of Bone Turnover, and Body Composition
Baseline (T0) | 6 months (T6) | P values + | 12 months (T12) | P values + | Difference (12 months) | P values (time)+ | |
---|---|---|---|---|---|---|---|
Bone mineral density
| |||||||
Lumbar spine (g/cm2) | 1.09 (1.07; 1.1) | 1.06 (1.05; 1.08) | 0.066 | 1.01 (0.99; 1.03) |
< 0.001
| − 0.08 (− 0.1; − 0.05) |
< 0.001
|
T-score | 0.26 (0.14; 0.38) | 0.07 (− 0.06; 0.2) | 0.113 | − 0.45 (− 0.63; − 0.28) |
< 0.001
| − 0.71 (− 0.97; − 0.45) |
< 0.001
|
Left hip (g/cm2) | 1.07 (1.04; 1.11) | 1.03 (0.99; 1.07) | 0.269 | 0.94 (0.89; 0.99) |
< 0.001
| − 0.13 (− 0.21; − 0.06) |
< 0.001
|
T-score | 0.85 (0.74; 0.96) | 0.3 (0.18; 0.41) |
< 0.001
| − 0.23 (− 0.38; − 0.08) |
< 0.001
| − 1.08 (− 1.3; − 0.86) |
< 0.001
|
Forearm (g/cm2) | 0.58 (0.58; 0.59) | 0.58 (0.58; 0.59) | 1.000 | 0.58 (0.57; 0.58) | 0.366 | − 0.01 (− 0.01; 0) | 0.295 |
T-score | − 0.17 (− 0.26; − 0.09) | − 0.2 (− 0.3; − 0.11) | 1.000 | − 0.38 (− 0.51; − 0.26) |
0.023
| − 0.21 (− 0.4; − 0.02) |
0.023
|
Total body (g/cm2) | 1.12 (1.11; 1.12) | 1.12 (1.11; 1.12) | 1.000 | 1.1 (1.09; 1.11) |
0.048
| − 0.01 (− 0.03; − 0.01) |
0.029
|
T-score | 0.02 (− 0.06; 0.1) | 0.03 (− 0.06; 0.11) | 1.000 | − 0.15 (− 0.26; − 0.04) |
0.030
| − 0.16 (− 0.32; − 0.01) |
0.017
|
Bone turnover
| |||||||
Albumin (g/dl) | 45.3 (44.5; 46.2) | 41.8 (40.9; 42.8) |
< 0.001
| 42 (41; 43.1) |
< 0.001
| − 3.3 (− 5; − 1.6) |
< 0.001
|
CTX (ng/ml) | 0.1 (0.3; 0.3) | 0.9 (0.8; 0.9) |
< 0.001
| 0.9 (0.9; 1) |
< 0.001
| 0.6 (0.6; 0.7) |
< 0.001
|
Osteocalcin (ng/ml) | 17.1 (15; 19.2) | 36.2 (34; 38.5) |
< 0.001
| 41.1 (38.7; 43.5) |
< 0.001
| 24 (20.5; 27.5) |
< 0.001
|
Bone-specific alkaline phosphatase (ng/ml) | 13.4 (12; 14.8) | 15.7 (14.1; 17.2) |
0.050
| 18.5 (16.9; 20.1) |
< 0.001
| 5.1 (2.7; 7.5) |
< 0.001
|
P1NP (mg/l) | 47.2 (41.5; 52.9) | 82.4 (76.2; 88.6) |
< 0.001
| 90.4 (83.8; 97.1) |
< 0.001
| 43.2 (33.5; 53) |
< 0.001
|
iPTH (pg/ml) | 48.6 (45.3; 51.8) | 51.1 (47.6; 54.5) | 0.861 | 46.9 (43.2; 50.7) | 0.510 | − 1.6 (− 7.6; 4.4) | 0.256 |
25(OH)D (mmol/l) | 39.6 (34.6; 44.5) | 62.6 (57.3; 67.8) |
< 0.001
| 63.2 (57.5; 68.9) |
< 0.001
| 23.6 (15.1; 32.1) |
< 0.001
|
1,25(OH)2D (pg/ml) | 47.1 (43.5; 50.7) | 63.2 (59.4; 67) |
< 0.001
| 66.3 (62.2; 70.4) |
< 0.001
| 19.2 (13.2; 25.2) |
< 0.001
|
Ca (mmol/l) | 2.33 (2.3; 2.35) | 2.33 (2.3; 2.35) | 1.000 | 2.29 (2.26; 2.31) | 0.102 | − 0.04 (− 0.08; 0.01) | 0.051 |
Corr. Ca (mmol/l) | 2.17 (2.15; 2.19) | 2.21 (2.19; 2.23) |
0.027
| 2.17 (2.14; 2.19) | 0.742 | − 0.01 (− 0.04; 0.03) |
0.008
|
Phosphate (mmol/l) | 1.05 (1.01; 1.08) | 1.14 (1.1; 1.18) |
0.001
| 1.24 (1.2; 1.28) |
< 0.001
| 0.2 (0.13; 0.26) |
< 0.001
|
Body composition
| |||||||
BMI (kg/m2) | 43.8 (43.2; 44.5) | 31.9 (31.2; 32.6) |
< 0.001
| 28.3 (27.5; 29) |
< 0.001
| − 15.6 (− 16.7; − 14.4) |
< 0.001
|
Weight loss (%) | – | 26.9 (25.5; 28.4) |
< 0.001
| 35.6 (33.9; 37.3) |
< 0.001
| − 35.7 (− 33.3; − 38.1) |
< 0.001
|
WC (cm) | 127.9 (125.9; 129.9) | 102.1 (100; 104.3) |
< 0.001
| 95.4 (93; 97.8) |
< 0.001
| − 32.5 (− 36.1; − 29) |
< 0.001
|
TBF (%) | 39.4 (37.3; 41.5) | 35.6 (33.8; 37.5) |
< 0.001
| 32.4 (29.9; 34.5) |
< 0.001
| − 7.1 (− 10.9; − 3.3) |
< 0.001
|
LBM (%) | 55.2 (54.3; 56.1) | 63.8 (68.4; 64.8) |
< 0.001
| 69.7 (68.4; 70.9) |
< 0.001
| 14.5 (12.7; 16.3) |
< 0.001
|
ASM (%) | 25.0 (24.5; 25.5) | 28.5 (28.0; 29.0) |
< 0.001
| 31.2 (30.5; 31.9) |
< 0.001
| 6.3 (5.3; 7.2) |
< 0.001
|
Associations Between Vitamin D and Parameters of Bone Turnover and Laboratory Parameters
Variables | Vitamin D groups | Baseline (T0) mean (95%CI) | p value* | 6 months (T6) mean (95%CI) | 12 months (T12) mean (95%CI) | Difference 12 vs. 0 months p value+ | % | Difference at 12 months (groups) | group p value+ | Time p value+ | Group* time p value+ | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
mean (95%CI) | p value+ | |||||||||||
Albumin (g/dl) | adequate | 45.3 (44; 46.6) | 0.989 | 42.1 (40.8; 43.4) | 42.7 (41.4; 44) |
0.001
| − 6 | 1.8 (− 0.4; 4) | 0.111 | 0.181 |
< 0.001
| 0.437 |
inadequate | 45.4 (44.1; 46.6) | 41.5 (40; 42.9) | 40.9 (39.1; 42.6) |
< 0.001
| − 10 | |||||||
CTX (ng/ml) | adequate | 0.31 (0.25; 0.4) |
0.017
| 0.87 (0.81; 0.94) | 0.9 (0.84; 0.96) |
< 0.001
| 190 | − 0.09(− 0.2; 0.2) | 0.096 | 0.348 |
< 0.001
| 0.205 |
inadequate | 0.29 (0.22; 0.3) | 0.9 (0.83; 0.97) | 0.99 (0.9; 1.07) |
< 0.001
| 246 | |||||||
Osteocalcin (ng/ml) | adequate | 17.1 (14; 20.2) | 0.060 | 35.1 (32; 38.2) | 40.5 (37.4; 43.6) |
< 0.001
| 137 | − 1.6 (− 6.7; 3.5) | 0.542 | 0.415 |
< 0.001
| 0.635 |
inadequate | 17.1 (14.1; 20.1) | 37.7 (34.3; 41.1) | 42.1 (38; 46.1) |
< 0.001
| 146 | |||||||
BAP (ng/ml) | adequate | 13.5 (11.5; 15.5) |
0.014
| 15.7 (13.6; 17.8) | 20 (17.9; 22) |
< 0.001
| 48 | 4 (0.6; 7.4) |
0.022
| 0.197 |
< 0.001
| 0.107 |
inadequate | 13.3 (11.3; 15.3) | 15.6 (13.3; 17.9) | 16 (13.3; 18.6) | 0.116 | 20 | |||||||
P1NP (mg/l) | adequate | 46 (37.9; 54) | 0.164 | 78.1 (69.7; 86.5) | 90.9 (82.5; 99.3) |
< 0.001
| 98 | 2 (− 11.8; 15.8) | 0.775 | 0.444 |
< 0.001
| 0.377 |
inadequate | 48.6 (40.4; 56.7) | 87.7 (78.3; 97) | 88.9 (77.9; 99.8) |
< 0.001
| 83 | |||||||
iPTH (pg/ml) | adequate | 47.7 (43; 52.4) | 0.209 | 48.9 (44.2; 53.6) | 46.5 (41.9; 51.2) | 0.773 | − 2 | − 1 (− 8.9; 6.9) | 0.803 | 0.254 | 0.240 | 0.705 |
inadequate | 49.4 (44.8; 53.9) | 53.8 (48.6; 59.1) | 47.5 (41.2; 53.9) | 0.257 | − 4 | |||||||
25(OH)D (mmol/l) | adequate | 40.4 (34.6; 46.2) | 0.407 | 75.2 (69.4; 81) | 71.9 (66.1; 77.7) |
< 0.001
| 78 | 24.2 (14.4; 33.9) |
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
inadequate | 38.8 (33.3; 44.4) | 46.7 (40.2; 53.2) | 47.7 (39.8; 55.6) | 0.092 | 23 | |||||||
1,25(OH)2D (pg/ml) | adequate | 47.8 (42.6; 52.9) | 0.378 | 63.4 (58.3; 68.5) | 68 (62.8; 73.3) |
< 0.001
| 42 | 4.7 (− 4; 13.3) | 0.289 | 0.446 |
< 0.001
| 0.699 |
inadequate | 46.4 (41.4; 51.5) | 63 (57.2; 68.7) | 63.4 (56.5; 70.2) |
< 0.001
| 36 | |||||||
Ca (mmol/l) | adequate | 2.30 (2.27; 2.34) |
0.044
| 2.35 (2.32; 2.38) | 2.29 (2.26; 2.33) |
0.050
| 0 | 0.02 (− 0.04; 0.08) | 0.472 | 0.557 |
0.047
|
0.033
|
inadequate | 2.34 (2.31; 2.38) | 2.3 (2.27; 2.34) | 2.27 (2.23; 2.32) |
0.028
| − 3 | |||||||
Corr. Ca (mmol/l) | adequate | 2.15 (2.13; 2.18) |
0.026
| 2.23 (2.2; 2.26) | 2.17 (2.14; 2.2) |
< 0.001
| 1 | 0.01 (− 0.04; 0.06) | 0.610 | 0.523 |
0.011
|
0.025
|
inadequate | 2.19 (2.16; 2.21) | 2.18 (2.15; 2.22) | 2.16 (2.12; 2.2) | 0.443 | − 1 | |||||||
Phosphate (mmol/l) | adequate | 1.04 (0.99; 1.09) | 0.521 | 1.13 (1.08; 1.18) | 1.23 (1.18; 1.28) |
< 0.001
| 18 | − 0.04 (− 0.12; 0.05) | 0.393 | 0.384 |
< 0.001
| 0.877 |
inadequate | 1.06 (1.01; 1.11) | 1.14 (1.08; 1.2) | 1.27 (1.2; 1.34) |
< 0.001
| 20 |
BMD region | Vitamin D groups | Baseline (T0) | p value* | 6 months (T6) | p value* | 12 months (T12) | p value* | p value time* | p value group* |
---|---|---|---|---|---|---|---|---|---|
Lumbar spine
| adequate | 10% | 0.563 | 8% | 0.675 | 62% | 0.515 |
0.001
| 0.523 |
inadequate | 6% | 5% | 49% | ||||||
Left hip
| adequate | 0% | 0.768 | 4% | 0.765 | 38% | 0.758 |
< 0.001
| 0.757 |
inadequate | 0% | 6% | 45% | ||||||
Forearm
| adequate | 15% | 0.343 | 14% | 0.351 | 17% | 0.390 | 0.921 | 0.340 |
inadequate | 26% | 25% | 29% | ||||||
Total body
| adequate | 19% | 0.974 | 11% | 0.974 | 29% | 0.974 |
0.038
| 0.974 |
inadequate | 19% | 12% | 30% |