Brief observationPositive association between 25-hydroxy vitamin d levels and bone mineral density: a population-based study of younger and older adults☆
Section snippets
Data source and subjects
The National Health and Nutrition Examination Survey III (NHANES III) was conducted between 1988 and 1994 to study the health and nutritional status of noninstitutionalized residents in the United States (12). The final analysis with complete data included 13,432 subjects. The study protocol was reviewed and approved by the Human Research Committee of the Brigham and Women's Hospital, Boston, Massachusetts.
Measurement of bone mineral density and serum 25-hydroxy vitamin d levels
Total hip bone mineral density was measured by dual-energy X-ray absorptiometry 13, 14.
Results
Mean unadjusted 25-hydroxy vitamin D levels were highest in whites, intermediate in Mexican Americans, and lowest in blacks in both age groups (Table 1). In the younger age group, 21% of whites, 48% of Mexican Americans, and 76% of blacks had 25-hydroxy vitamin D levels below the midpoint of the reference range (58.3 nmol/L). Among older adults, 32% of whites, 55% of Mexican Americans, and 67% of blacks had levels below the reference midpoint. Blacks had the highest bone mineral density and
Discussion
In this representative sample of ambulatory adults in the United States, we found a significant positive association between 25-hydroxy vitamin D levels and total hip bone mineral density in both younger and older adults. The association did not differ between men and women. Higher 25-hydroxy vitamin D levels were associated with greater bone mineral density throughout the reference range in all subgroups, suggesting that it may be advantageous to be at the upper end of the reference range (90
Acknowledgements
The authors are indebted to Matthew H. Liang, MD, MPH, and Stephen Mario Ferrari for their insight and assistance in the preparation of this manuscript.
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The study was supported by the Harvard Hartford Foundation, the International Foundation for the Promotion of Nutrition Research and Nutrition Education, and the Swiss Foundation for Nutrition Research.