Khodabakhshi Adeleh, Davoodi Sayed Hossein, Vahid Farhad
Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
BMC Nutr. 2023 Mar 14;9(1):48. doi: 10.1186/s40795-023-00707-y.
Osteoporosis is a health complication worldwide, especially in developing countries. The prevalence was reported to be 18.3% globally. While the effect of biochemical factors on fracture risk/odds has been documented, the association/correlation between serum 25(OH)D levels, vitamin D dietary intake, and sun exposure with bone mineral density (BMD) remains controversial. This study aimed to evaluate the association and correlation between vitamin D status, including serum levels, dietary intakes, and sun exposure with BMD. We hypothesized that vitamin D-related factors would have different correlations/associations with BMD, which would help better evaluate future studies' results.
A total of 186 individuals were included in this study (winter 2020). BMD was measured by Dual-energy X-ray absorptiometry. Blood serum levels of 25(OH)D, phosphorus, calcium, parathyroid hormone (PTH), and calcitonin were tested using standard lab tests. Valid and reliable questionnaires were used for sun exposure assessment and dietary intakes.
There was a significant protective association between spine BMD (classifications, two groups) (OR = 0.69, 95%CI: 0.50-0.94; p-value = 0.023), BMD diagnosis (classifications, two groups) (OR = 0. 69, 95%CI: 0.49-0.87; p-value = 0.036) and sun exposure. There was a significant and moderate correlation between Spine measurements (Spine BMD: Pearson correlation coefficient = 0.302, p-value = 0.046; Spine T-score: Pearson correlation coefficient = 0.322, p-value = 0.033, Spine Z-score: Pearson correlation coefficient = 0.328, p-value = 0.030) and serum 25(OH)D. In addition, participants with osteopenia and osteoporosis significantly consume a higher amount of soluble fiber than the normal BMD group. There was no significant correlation between vitamin D intake and BMD.
In conclusion, serum 25(OH)D levels and sun exposure are correlated and associated with BMD. However, prospective studies are needed to investigate the association between dietary vitamin D intake and BMD.
骨质疏松是一个全球性的健康问题,在发展中国家尤为突出。据报道,全球患病率为18.3%。虽然生化因素对骨折风险/几率的影响已有文献记载,但血清25(OH)D水平、维生素D饮食摄入量以及日照与骨密度(BMD)之间的关联/相关性仍存在争议。本研究旨在评估维生素D状态(包括血清水平、饮食摄入量和日照)与BMD之间的关联和相关性。我们假设与维生素D相关的因素与BMD有不同的相关性/关联,这将有助于更好地评估未来研究的结果。
本研究共纳入186名个体(2020年冬季)。采用双能X线吸收法测量骨密度。使用标准实验室检测方法检测血清25(OH)D、磷、钙、甲状旁腺激素(PTH)和降钙素水平。使用有效且可靠的问卷进行日照评估和饮食摄入量调查。
脊柱骨密度(分类,两组)(OR = 0.69,95%CI:0.50 - 0.94;p值 = 0.023)、骨密度诊断(分类,两组)(OR = 0.69,95%CI:0.49 - 0.87;p值 = 0.036)与日照之间存在显著的保护关联。脊柱测量值(脊柱骨密度:Pearson相关系数 = 0.302,p值 = 0.046;脊柱T评分:Pearson相关系数 = 0.322,p值 = 0.033,脊柱Z评分:Pearson相关系数 = 0.328,p值 = 0.030)与血清25(OH)D之间存在显著且中等程度的相关性。此外,骨质减少和骨质疏松患者比骨密度正常组显著摄入更多的可溶性纤维。维生素D摄入量与骨密度之间无显著相关性。
总之,血清25(OH)D水平和日照与骨密度相关且存在关联。然而,需要进行前瞻性研究来调查饮食中维生素D摄入量与骨密度之间的关联。