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维生素D代谢物与骨密度:动脉粥样硬化的多民族研究。

Vitamin D metabolites and bone mineral density: The multi-ethnic study of atherosclerosis.

作者信息

van Ballegooijen Adriana J, Robinson-Cohen Cassianne, Katz Ronit, Criqui Michael, Budoff Matthew, Li Dong, Siscovick David, Hoofnagle Andy, Shea Steven J, Burke Gregory, de Boer Ian H, Kestenbaum Bryan

机构信息

University of Washington, Kidney Research Institute, Seattle, WA, USA.

University of Washington, Kidney Research Institute, Seattle, WA, USA.

出版信息

Bone. 2015 Sep;78:186-93. doi: 10.1016/j.bone.2015.05.008. Epub 2015 May 11.

Abstract

Previous studies demonstrate associations of low 25-hydroxyvitamin D (25(OH)D) concentrations with low bone mineral density (BMD) and fractures, motivating widespread use of vitamin D supplements for bone health. However, previous studies have been limited to predominantly White populations despite differences in the distribution and metabolism of 25(OH)D by race/ethnicity. We determined associations of serum 25(OH)D, 24,25-dihydroxyvitamin D (24,25(OH2)D3), and parathyroid hormone (PTH) with BMD among 1773 adult participants in the Multi-Ethnic Study of Atherosclerosis (MESA) in a staggered cross-sectional study design. Vitamin D metabolites were measured using liquid chromatography-mass spectroscopy and PTH using a 2-site immunoassay from serum collected in 2000-2002. Volumetric trabecular lumbar BMD was measured from computed tomography scans performed in 2002-2005 expressed as g/cm(3). We used linear regression and graphical methods to compare associations of vitamin D metabolite and PTH concentrations with BMD as the outcomes measure among White (n=714), Black (n=353), Chinese (n=249), and Hispanic (n=457) participants. Serum 25(OH)D and 24,25(OH2)D3 concentrations were highest among Whites and lowest among Blacks. BMD was greatest among Black participants. Higher serum 25(OH)D was only associated with higher BMD among Whites and Chinese participants (P-for-interaction=0.054). Comparing the lowest category of 25(OH)D (<20 ng/ml) to the highest (≥30 ng/ml), the adjusted mean difference in BMD was -8.1g/cm3 (95% CI -14.8, -1.4) for Whites; -10.2g/cm3 (-20.4, 0.0) for Chinese vs. 8.8 g/cm3 (-2.8, 20.5) for Black and -1.1g/cm3 (-8.3, 6.2) for Hispanic. Similar results were observed for serum 24,25(OH2)D3. Serum PTH was not associated with BMD. In a multi-ethnic population, associations of 25(OH)D with BMD were strongest among White and Chinese participants and null among Black and Hispanic participants. Further studies are needed to determine optimal biomarkers for bone health for multiple ethnic groups.

摘要

以往研究表明,25-羟基维生素D(25(OH)D)浓度低与骨矿物质密度(BMD)低及骨折有关,这促使维生素D补充剂被广泛用于骨骼健康。然而,尽管25(OH)D的分布和代谢因种族/民族而异,但以往研究主要局限于白人人群。在一项交错横断面研究设计中,我们在动脉粥样硬化多民族研究(MESA)的1773名成年参与者中,确定了血清25(OH)D、24,25-二羟基维生素D(24,25(OH2)D3)和甲状旁腺激素(PTH)与BMD之间的关联。使用液相色谱-质谱法测量维生素D代谢物,使用两点免疫分析法测量2000 - 2002年采集血清中的PTH。从2002 - 2005年进行的计算机断层扫描测量腰椎骨小梁体积BMD,单位为g/cm³。我们使用线性回归和图形方法,比较白人(n = 714)、黑人(n = 353)、中国人(n = 249)和西班牙裔(n = 457)参与者中维生素D代谢物和PTH浓度与BMD的关联,以BMD作为结果指标。白人血清25(OH)D和24,25(OH2)D3浓度最高,黑人最低。黑人参与者的BMD最高。仅在白人和中国参与者中,较高的血清25(OH)D与较高的BMD相关(交互作用P值 = 0.054)。将25(OH)D最低类别(<20 ng/ml)与最高类别(≥30 ng/ml)进行比较,白人BMD的调整后平均差异为-8.1g/cm³(95%CI -14.8,-1.4);中国人为-10.2g/cm³(-20.4,0.0);黑人为8.8 g/cm³(-2.8,20.5);西班牙裔为-1.1g/cm³(-8.3,6.2)。血清24,25(OH2)D3也观察到类似结果。血清PTH与BMD无关。在多民族人群中,25(OH)D与BMD的关联在白人和中国参与者中最强,在黑人和西班牙裔参与者中无关联。需要进一步研究以确定多个种族群体骨骼健康的最佳生物标志物。

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