维生素 D 代谢物比值与老年男性的容积骨密度相关。
The Vitamin D Metabolite Ratio Is Associated With Volumetric Bone Density in Older Men.
机构信息
Division of Nephrology-Hypertension, University of California, San Diego, CA 92037, USA.
California Pacific Medical Center Research Institute, Department of Epidemiology, University of California, SanFrancisco, San Francisco, CA 94107, USA.
出版信息
J Clin Endocrinol Metab. 2024 Jan 18;109(2):e513-e521. doi: 10.1210/clinem/dgad587.
CONTEXT
Serum 25-hydroxyvitamin D (25(OH)D) is the current marker of vitamin D adequacy, but its relationship with bone health has been inconsistent. The ratio of 24,25-dihydroxyvitamin D3 to 25(OH)D3 (vitamin D metabolite ratio or VMR) is a marker of vitamin D that has been associated with longitudinal changes in bone mineral density (BMD) and fracture risk.
OBJECTIVE
High-resolution peripheral quantitative computed tomography (HR-pQCT) provides information on bone health beyond standard dual-energy x-ray absorptiometry, in that it measures volumetric BMD (vBMD) as well bone strength. The relationship of the VMR with vBMD and bone strength remains unknown.
METHODS
We evaluated the associations of the VMR and 25(OH)D3 with vBMD and bone strength in the distal radius and tibia, assessed by HR-pQCT in 545 older men participating in the Osteoporotic Fractures in Men (MrOS) Study. Primary outcomes were vBMD and estimated failure load (EFL, a marker of bone strength) at the distal radius and tibia.
RESULTS
The mean age was 84 ± 4 years, 88.3% were White, and 32% had an estimated glomerular filtration rate <60 mL/min/1.73 m2. In adjusted models, each twofold higher VMR was associated with a 9% (3%, 16%) higher total vBMD and a 13% (5%, 21%) higher EFL at the distal radius. Results were similar at the distal tibia. 25(OH)D3 concentrations were not associated with any of the studied outcomes.
CONCLUSION
Among older men, a higher VMR was associated with greater vBMD and bone strength while 25(OH)D3 was not. The VMR may serve as a valuable marker of skeletal health in older men.
背景
血清 25-羟维生素 D（25(OH)D）是目前维生素 D 充足的标志物，但它与骨骼健康的关系一直不一致。24,25-二羟维生素 D3 与 25(OH)D3 的比值（维生素 D 代谢物比值或 VMR）是与骨密度（BMD）和骨折风险的纵向变化相关的维生素 D 标志物。
目的
高分辨率外周定量计算机断层扫描（HR-pQCT）提供了超越标准双能 X 射线吸收法的骨骼健康信息，因为它测量体积 BMD（vBMD）以及骨骼强度。VMR 与 vBMD 和骨强度的关系尚不清楚。
方法
我们评估了 VMR 和 25(OH)D3 与 HR-pQCT 评估的 545 名老年男性（男性骨质疏松性骨折研究 [MrOS]）桡骨远端和胫骨 vBMD 和骨强度的关系。主要结局是桡骨远端和胫骨的 vBMD 和估计的失效负荷（EFL，骨强度的标志物）。
结果
平均年龄为 84 ± 4 岁，88.3%为白人，32%估计肾小球滤过率 <60 mL/min/1.73 m2。在调整后的模型中，VMR 每增加两倍，桡骨远端的总 vBMD 增加 9%（3%，16%），EFL 增加 13%（5%，21%）。在胫骨远端也有类似的结果。25(OH)D3 浓度与研究的任何结果均无关。
结论
在老年男性中，VMR 较高与 vBMD 和骨强度较高相关，而 25(OH)D3 则不然。VMR 可能是老年男性骨骼健康的有价值标志物。
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