Sohl E, de Jongh R T, Swart K M A, Enneman A W, van Wijngaarden J P, van Dijk S C, Ham A C, van der Zwaluw N L, Brouwer-Brolsma E M, van der Velde N, de Groot C P G M, te Velde S J, Lips P, van Schoor N M
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Room A517, 1081 BT, Amsterdam, The Netherlands.
Calcif Tissue Int. 2015 Feb;96(2):113-22. doi: 10.1007/s00223-014-9943-7. Epub 2014 Dec 25.
The association of vitamin D status with bone mineral density (BMD) and Quantitative Ultrasound measurements (QUS) has been inconsistent in previous studies, probably caused by moderating effects. This study explored (1) the association of vitamin D status with QUS and BMD, and (2) whether these associations were modified by body mass index (BMI), age, gender, or physical activity. Two-independent cohorts of the Longitudinal Aging Study Amsterdam (LASA-I, 1995/1996, aged ≥65; LASA-II, 2008/2009, aged 61-71) and baseline measurement of the B-vitamins for the prevention of osteoporotic fractures (B-PROOF) study (2008-2011, aged 65+) were used. QUS measurements [broadband ultrasound attenuation (BUA) and speed of sound (SOS)] were performed at the calcaneus in all three cohorts (N = 1,235, N = 365, N = 1319); BMD was measured by Dual X-ray absorptiometry (DXA) in B-PROOF (N = 1,162 and 1,192 for specific sites) and LASA-I (N = 492 and 503). The associations of vitamin D status with BUA and BMD were modified by BMI. Only in persons with low-to-normal BMI (<25 kg/m(2)) and serum 25(OH)D <25 nmol/L was associated with lower BUA as compared to the reference group (≥50 nmol/L) in LASA-I and B-PROOF. Furthermore, in LASA-I, these individuals had lower BMD at the hip and lumbar spine. In LASA-II, no associations with BUA were observed. Vitamin D status was not associated with SOS, and these associations were not modified by the effect modifiers tested. The association between vitamin D status and BUA and BMD was modified by BMI in the older-aged cohorts: there was only an association in individuals with BMI <25 kg/m(2).
维生素D状态与骨矿物质密度（BMD）及定量超声测量值（QUS）之间的关联在以往研究中并不一致，这可能是由调节效应导致的。本研究探讨了：（1）维生素D状态与QUS及BMD之间的关联；（2）这些关联是否会因体重指数（BMI）、年龄、性别或体力活动而改变。研究使用了阿姆斯特丹纵向衰老研究的两个独立队列（LASA - I，1995/1996年，年龄≥65岁；LASA - II，2008/2009年，年龄61 - 71岁）以及预防骨质疏松性骨折的B族维生素（B - PROOF）研究的基线测量数据（2008 - 2011年，年龄65岁以上）。在所有三个队列中（N分别为1235、365、1319）均对跟骨进行了QUS测量[宽带超声衰减（BUA）和声速（SOS）]；在B - PROOF队列（特定部位的N分别为1162和1192）以及LASA - I队列（N分别为492和503）中通过双能X线吸收法（DXA）测量了BMD。维生素D状态与BUA及BMD之间的关联受到BMI的影响。仅在BMI低至正常（<25 kg/m²）且血清25(OH)D<25 nmol/L的人群中，与LASA - I和B - PROOF中的参照组（≥50 nmol/L）相比，其BUA较低。此外，在LASA - I中，这些个体的髋部和腰椎BMD较低。在LASA - II中，未观察到与BUA的关联。维生素D状态与SOS无关，且这些关联不受所测试的效应修饰因素的影响。在老年队列中，维生素D状态与BUA及BMD之间的关联受到BMI的影响：仅在BMI<25 kg/m²的个体中存在关联。
