O'Leary Thomas J, Izard Rachel M, Jackson Sarah, Walsh Neil P, Carswell Alexander T, Oliver Samuel J, Allan Donald, Rhodes Lesley E, Tang Jonathan C Y, Fraser William D, Greeves Julie P
Army Health and Performance Research, Army Headquarters, Hampshire SP11 8HT, United Kingdom.
Division of Surgery and Interventional Science, UCL, London W1T 7HA, United Kingdom.
J Bone Miner Res. 2025 Jun 25;40(7):847-859. doi: 10.1093/jbmr/zjaf064.
Vitamin D may mitigate bone stress injuries in military training by modulating changes in bone. This cross-sectional observational study (Study 1) and randomized controlled trial (Study 2) investigated associations between vitamin D metabolites and tibial structure and density, and the effect of vitamin D supplementation on tibial adaptations to military training. A total of 343 (Study 1) and 194 (Study 2) male British Army recruits participated. Circulating vitamin D metabolites (biologically "active" and "inactive") and tibial structure were measured in participants during week 1 and week 12 (Study 2 only) of initial military training. Associations between vitamin D metabolites and HRpQCT outcomes at week 1 were tested in Study 1. Participants in Study 2 were randomly assigned to vitamin D (oral pill or simulated sunlight) or placebo (placebo pill or placebo simulated sunlight) supplementation for 12 wk designed to achieve vitamin D sufficiency. There was no association between total 25(OH)D or vitamin D receptor single-nucleotide polymorphisms and any measure of density, geometry, or microarchitecture (p ≥ .063). Higher 1,25(OH)2D was associated with lower cortical porosity and perimeter (p ≤ .040). Higher total 24,25(OH)2D was associated with higher trabecular number and lower trabecular thickness (p = .016). Higher 25(OH)D:24,25(OH)2D (VMR 1) was associated with higher trabecular thickness, trabecular separation, and cortical porosity (p ≤ .034). Higher 1,25(OH)2D:24,25(OH)2D (VMR 2) was associated with lower trabecular number, and higher trabecular spacing and thickness (p ≤ .035). There was no effect of vitamin D supplementation on any tibial outcome. Training decreased trabecular area (-0.1%), thickness (-4.4%), and separation (-2.1%), and increased cortical thickness (0.8%) and area (0.9%) (p ≤ .042). Vitamin D metabolites and their ratios were associated with tibial size and microarchitecture, but vitamin D supplementation had no impact on the adaptive response to military training.
维生素D可能通过调节骨骼变化来减轻军事训练中的骨骼应激损伤。这项横断面观察性研究（研究1）和随机对照试验（研究2）调查了维生素D代谢物与胫骨结构和密度之间的关联，以及补充维生素D对胫骨适应军事训练的影响。共有343名（研究1）和194名（研究2）英国陆军男性新兵参与。在初始军事训练的第1周和第12周（仅研究2）测量参与者的循环维生素D代谢物（生物学上的“活性”和“非活性”）和胫骨结构。在研究1中测试了第1周时维生素D代谢物与高分辨率外周定量计算机断层扫描（HRpQCT）结果之间的关联。研究2的参与者被随机分配接受维生素D（口服药丸或模拟阳光）或安慰剂（安慰剂药丸或安慰剂模拟阳光）补充12周，旨在实现维生素D充足。总25（OH）D或维生素D受体单核苷酸多态性与任何密度、几何形状或微观结构测量之间均无关联（p≥0.063）。较高的1,25（OH）2D与较低的皮质孔隙率和周长相关（p≤0.040）。较高的总24,25（OH）2D与较高的小梁数量和较低的小梁厚度相关（p = 0.016）。较高的25（OH）D:24,25（OH）2D（VMR 1）与较高的小梁厚度、小梁间距和皮质孔隙率相关（p≤0.034）。较高的1,25（OH）2D:24,25（OH）2D（VMR 2）与较低的小梁数量以及较高的小梁间距和厚度相关（p≤0.035）。补充维生素D对任何胫骨结果均无影响。训练使小梁面积减少（-0.1%）、厚度减少（-4.4%）和间距减少（-2.1%），并使皮质厚度增加（0.8%）和面积增加（0.9%）（p≤0.042）。维生素D代谢物及其比率与胫骨大小和微观结构相关，但补充维生素D对军事训练的适应性反应没有影响。
