Why don't serum Vitamin D concentrations associate with BMD by DXA?

A case of being 'bound' to the wrong assay? Implications for Vitamin D screening

Richard J. Allison, Abdulaziz Farooq, Anissa Cherif, Bruce Hamilton, Graeme L. Close, Mathew G. Wilson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population. Methods: In 604 male athletes (Arab (n=327), Asian (n=48), Black (n=108), Caucasian (n=53) and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Bioavailable vitamin D was calculated using the free hormone hypothesis. Results: From 604 athletes, 21.5% (n=130) demonstrated severe 25(OH)D deficiency, 37.1% (n=224) deficiency, 26% (n=157) insufficiency and 15.4% (n=93) sufficiency. Serum 25(OH)D concentrations were not associated with BMD at any site. After adjusting for age and race, bioavailable vitamin D was associated with BMD (spine, neck and hip). Mean serum vitamin D binding protein concentrations were not associated with 25(OH)D concentrations (p=0.392). Conclusion: Regardless of age or race, bioavailable vitamin D and not serum 25(OH)D was associated with BMD in a racially diverse athletic population. If vitamin D screening is warranted, clinicians should use appropriate assays to calculate vitamin D binding protein and bioavailable vitamin D levels concentrations than serum 25(OH)D. In turn, prophylactic vitamin D supplementation to â 'correct' insufficient athletes should not be based on serum 25(OH)D measures.

Original languageEnglish
Pages (from-to)522-526
Number of pages5
JournalBritish Journal of Sports Medicine
Volume52
Issue number8
DOIs
Publication statusPublished - Apr 2018

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Vitamin D
Bone Density
Vitamin D-Binding Protein
Serum
Athletes
Sports
Population
Hispanic Americans
Hip
Blood Proteins
Spine
Neck
Hormones
Bone and Bones
Health

Cite this

Allison, Richard J. ; Farooq, Abdulaziz ; Cherif, Anissa ; Hamilton, Bruce ; Close, Graeme L. ; Wilson, Mathew G. / Why don't serum Vitamin D concentrations associate with BMD by DXA? A case of being 'bound' to the wrong assay? Implications for Vitamin D screening. In: British Journal of Sports Medicine. 2018 ; Vol. 52, No. 8. pp. 522-526.
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abstract = "Background: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population. Methods: In 604 male athletes (Arab (n=327), Asian (n=48), Black (n=108), Caucasian (n=53) and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Bioavailable vitamin D was calculated using the free hormone hypothesis. Results: From 604 athletes, 21.5{\%} (n=130) demonstrated severe 25(OH)D deficiency, 37.1{\%} (n=224) deficiency, 26{\%} (n=157) insufficiency and 15.4{\%} (n=93) sufficiency. Serum 25(OH)D concentrations were not associated with BMD at any site. After adjusting for age and race, bioavailable vitamin D was associated with BMD (spine, neck and hip). Mean serum vitamin D binding protein concentrations were not associated with 25(OH)D concentrations (p=0.392). Conclusion: Regardless of age or race, bioavailable vitamin D and not serum 25(OH)D was associated with BMD in a racially diverse athletic population. If vitamin D screening is warranted, clinicians should use appropriate assays to calculate vitamin D binding protein and bioavailable vitamin D levels concentrations than serum 25(OH)D. In turn, prophylactic vitamin D supplementation to {\^a} 'correct' insufficient athletes should not be based on serum 25(OH)D measures.",
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Why don't serum Vitamin D concentrations associate with BMD by DXA? A case of being 'bound' to the wrong assay? Implications for Vitamin D screening. / Allison, Richard J.; Farooq, Abdulaziz; Cherif, Anissa; Hamilton, Bruce; Close, Graeme L.; Wilson, Mathew G.

In: British Journal of Sports Medicine, Vol. 52, No. 8, 04.2018, p. 522-526.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Why don't serum Vitamin D concentrations associate with BMD by DXA?

T2 - A case of being 'bound' to the wrong assay? Implications for Vitamin D screening

AU - Allison, Richard J.

AU - Farooq, Abdulaziz

AU - Cherif, Anissa

AU - Hamilton, Bruce

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AU - Wilson, Mathew G.

PY - 2018/4

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N2 - Background: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population. Methods: In 604 male athletes (Arab (n=327), Asian (n=48), Black (n=108), Caucasian (n=53) and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Bioavailable vitamin D was calculated using the free hormone hypothesis. Results: From 604 athletes, 21.5% (n=130) demonstrated severe 25(OH)D deficiency, 37.1% (n=224) deficiency, 26% (n=157) insufficiency and 15.4% (n=93) sufficiency. Serum 25(OH)D concentrations were not associated with BMD at any site. After adjusting for age and race, bioavailable vitamin D was associated with BMD (spine, neck and hip). Mean serum vitamin D binding protein concentrations were not associated with 25(OH)D concentrations (p=0.392). Conclusion: Regardless of age or race, bioavailable vitamin D and not serum 25(OH)D was associated with BMD in a racially diverse athletic population. If vitamin D screening is warranted, clinicians should use appropriate assays to calculate vitamin D binding protein and bioavailable vitamin D levels concentrations than serum 25(OH)D. In turn, prophylactic vitamin D supplementation to â 'correct' insufficient athletes should not be based on serum 25(OH)D measures.

AB - Background: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population. Methods: In 604 male athletes (Arab (n=327), Asian (n=48), Black (n=108), Caucasian (n=53) and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Bioavailable vitamin D was calculated using the free hormone hypothesis. Results: From 604 athletes, 21.5% (n=130) demonstrated severe 25(OH)D deficiency, 37.1% (n=224) deficiency, 26% (n=157) insufficiency and 15.4% (n=93) sufficiency. Serum 25(OH)D concentrations were not associated with BMD at any site. After adjusting for age and race, bioavailable vitamin D was associated with BMD (spine, neck and hip). Mean serum vitamin D binding protein concentrations were not associated with 25(OH)D concentrations (p=0.392). Conclusion: Regardless of age or race, bioavailable vitamin D and not serum 25(OH)D was associated with BMD in a racially diverse athletic population. If vitamin D screening is warranted, clinicians should use appropriate assays to calculate vitamin D binding protein and bioavailable vitamin D levels concentrations than serum 25(OH)D. In turn, prophylactic vitamin D supplementation to â 'correct' insufficient athletes should not be based on serum 25(OH)D measures.

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KW - Bone Density

KW - Humans

KW - Biological Availability

KW - Male

KW - Athletes

KW - Absorptiometry, Photon

KW - Young Adult

KW - Adolescent

KW - Adult

KW - Biomarkers/blood

KW - Vitamin D-Binding Protein/blood

KW - Vitamin D/blood

KW - Parathyroid Hormone/blood

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JO - British Journal of Sports Medicine

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