Total 25-hydroxyvitamin D levels predict fracture risk: results from the 15-year follow-up of the Japanese Population-based Osteoporosis (JPOS) Cohort Study.

Abstract

We found that community-dwelling women with 25-hydroxyvitamin D levels <20 ng/mL compared to levels ≥20 ng/mL indicated increased risks for clinical, non-vertebral, and fragility fractures during 5 years. Furthermore, the increased risks of non-vertebral fractures remained significant in 10 and 15 years after adjusting for age and bone mineral density.

INTRODUCTION:

We examined whether total 25-hydroxyvitamin D (25[OH]D) levels are associated with fracture risk over 15 years in a Japanese female cohort.

METHODS:

Of 1437 community-dwelling women aged ≥50 years in the baseline survey, 1236 provided information regarding fractures during a 15-year follow-up period. The analysis included 1211 women without early menopause or diseases affecting bone metabolism.

RESULTS:

Over 15 years, 269 clinical (224 non-vertebral, 149 fragility) fracture events were confirmed. Incidence rates categorized by 25(OH)D levels (<10, 10-20, 20-30, and ≥30 ng/mL) indicated a significant divergence for any clinical fractures in 5 years (log rank test p = 0.016) and for non-vertebral fractures in 5, 10, and 15 years (p < 0.001, p = 0.001, p = 0.017, respectively). Hazard ratios (HRs) for 25(OH)D levels <10 and 10-20 ng/mL compared to levels ≥30 ng/mL during 5 years indicated significances for clinical fractures (HR 4.93 with p = 0.009, HR 3.00 with p = 0.034) and for non-vertebral fractures (HR 6.55 with p = 0.005, HR 3.49 with p = 0.036). Those with levels <20 ng/mL compared to those with levels ≥20 ng/mL indicated significant increased risks for clinical fractures (HR 1.72 with p = 0.010), non-vertebral fractures (HR 2.45 with p < 0.001), and fragility fractures (HR 2.00 with p = 0.032) in 5 years. The HR of non-vertebral fractures for levels <20 ng/mL remained significant during 15 years (HR 1.42 with p = 0.012) after adjustment for age and femoral neck bone mineral density.

CONCLUSIONS:

Low 25(OH)D levels, especially <20 ng/mL, were associated with elevated fracture risks in Japanese women.

• Authors: J Tamaki, M Iki, Y Sato, E Kajita, H Nishino, T Akiba, T Matsumoto, S Kagamimori, JPOS Study Group
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 28 Issue 6 Pg. 1903-1913 (06 2017) ISSN: 1433-2965 [Electronic] England
• PMID: 28243705 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adolescent
• Adult
• Aged
• Biomarkers (blood)
• Body Size (physiology)
• Bone Density (physiology)
• Cohort Studies
• Female
• Femur Neck (physiopathology)
• Follow-Up Studies
• Humans
• Incidence
• Japan (epidemiology)
• Kaplan-Meier Estimate
• Lumbar Vertebrae (physiopathology)
• Middle Aged
• Osteoporosis, Postmenopausal (blood, epidemiology, physiopathology)
• Osteoporotic Fractures (blood, epidemiology, physiopathology)
• Predictive Value of Tests
• Risk Assessment (methods)
• Vitamin D (analogs & derivatives, blood)
• Young Adult