Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T06:37:25.095Z Has data issue: false hasContentIssue false
  • English
  • Français

Vitamin D status of 51–75-year-old Irish women: its determinants and impact on biochemical indices of bone turnover

Published online by Cambridge University Press:  02 January 2007

Tom R Hill ,
Maria M O'Brien ,
Christel Lamberg-Allardt ,
Jette Jakobsen ,
Mairead Kiely ,
Albert Flynn  and
Kevin D Cashman
Tom R Hill
Affiliation:
Department of Food and Nutritional Sciences, University College, Cork, Ireland:
Maria M O'Brien
Affiliation:
Department of Food and Nutritional Sciences, University College, Cork, Ireland:
Christel Lamberg-Allardt
Affiliation:
Calcium Research Unit, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland:
Jette Jakobsen
Affiliation:
Danish Institute for Food and Veterinary Research, Söborg, Denmark:
Mairead Kiely
Affiliation:
Department of Food and Nutritional Sciences, University College, Cork, Ireland:
Albert Flynn
Affiliation:
Department of Food and Nutritional Sciences, University College, Cork, Ireland:
Kevin D Cashman*
Affiliation:
Department of Food and Nutritional Sciences, University College, Cork, Ireland: Department of Medicine, University College, Cork, Ireland
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives

To assess the vitamin D status of Irish postmenopausal women during wintertime, and to examine its relationship with serum parathyroid hormone (PTH) and biochemical markers of bone turnover. In addition, the determinants of wintertime serum 25-hydroxyvitamin D (25OH–D) levels in these women were investigated.

Design

A cross-sectional observational study.

Setting

Cork City, Ireland (52°N).

Subjects

Ninety-five apparently healthy, free-living postmenopausal women (aged 51–75 years), not taking any medication and free from any condition likely to affect vitamin D status or calcium/bone metabolism.

Results

Forty-eight per cent and 7% of women had serum 25OH–D levels <50 nmol l−1 and <25 nmol l−1, respectively. 25OH–D levels in these women were positively associated with dietary calcium intake (P = 0.0002) and use of vitamin D-containing supplements (P = 0.031), and negatively associated with cigarette smoking (P = 0.027) and body mass index (BMI) (P = 0.030). Low serum 25OH-D levels (<50 nmol l−1) were associated (P <0.01) with elevated serum PTH levels. There were no significant differences in urinary pyridinium crosslinks or serum osteocalcin, biochemical indices of bone turnover, between subjects with serum 25OH–D levels above or below 50 nmol l−1.

Conclusions

A high proportion of Irish postmenopausal women had low vitamin D status (< 50 nmol l−1) during late wintertime, which appeared to lead to elevated levels of serum PTH but not of bone turnover markers. Use of regular low-dose supplemental vitamin D, meeting daily calcium recommendations, cessation of smoking and maintaining BMI in the normal range are important factors that could help maintain adequate vitamin D levels during wintertime in these women.

Keywords

Vitamin D statusDeterminantsPostmenopausal womenBone turnover
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 2 , April 2006 , pp. 225 - 233
Copyright
Copyright © The Authors 2006

References

1Parfitt, AM, Gallagher, JC, Heaney, RP, Johnston, CC, Neer, R, Whedon, GD. Vitamin D and bone health in the elderly. American Journal of Clinical Nutrition 1982; 36: 1014–31.CrossRefGoogle ScholarPubMed
2Stamp, TC, Round, JM. Seasonal changes in human plasma levels of 25-hydroxyvitamin D. Nature 1974; 247: 563–5.CrossRefGoogle Scholar
3McKenna, MJ. Differences in vitamin D, status between countries in young adults and the elderly. American Journal of Clinical Nutrition 1992; 93: 69–77.Google ScholarPubMed
4Van der Wielen, RPJ, Lowik, MRH, Van Den Berg, H, De Groot, LCPGM, Haller, J, Moreiras, O, et al. Serum vitamin D concentrations among elderly people in Europe. Lancet 1995; 346: 207–10.CrossRefGoogle ScholarPubMed
5Lips, P, Duong, T, Oleksik, A, Black, D, Cummings, S, Cox, D, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. Journal of Clinical Endocrinology and Metabolism 2001; 86: 1212–21.CrossRefGoogle ScholarPubMed
6Webb, AR, Kline, L, Holick, MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3 : exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. Journal of Clinical Endocrinology and Metabolism 1988; 67: 373–8.CrossRefGoogle Scholar
7Food and Agriculture Organization (FAO)/World Health Organization (WHO). Human Vitamin and Mineral Requirements . Report of the Joint FAO/WHO Expert Consultation, Bangkok, Thailand. Rome: Food and Nutrition Division, FAO, 1998; Also available at http://ftp.fao.org/es/esn/nutrition.Google Scholar
8Ovesen, L, Andersen, R, Jakobsen, J. Geographical differences in vitamin D status, with particular reference to European countries. Proceedings of the Nutrition Society 2003; 62: 813–21.CrossRefGoogle ScholarPubMed
9Hill, TR, O'Brien, MM, Kiely, M, Flynn, A, Cashman, KD. Vitamin D intakes in 18–64 year-old Irish adults. European Journal of Clinical Nutrition 2004; 58: 1509–17.CrossRefGoogle Scholar
10Lips, P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocrine Reviews 2001; 22: 477–501.CrossRefGoogle ScholarPubMed
11Lips, P. Which circulating level of 25-hydroxyvitamin D is appropriate?. Journal of Steroid Biochemistry and Molecular Biology 2004; 89–90: 611–4.CrossRefGoogle ScholarPubMed
12Hill, T, Collins, A, O'Brien, MM, Kiely, M, Flynn, A, Cashman, KD. Vitamin D intake and status in Irish postmenopausal women. European Journal of Clinical Nutrition 2005; 59: 404–10.CrossRefGoogle ScholarPubMed
13Krall, EA, Sahyoun, N, Tannenbaum, S, Dallal, GE, Dawson-Hughes, B. Effect of vitamin D intake on seasonal variations in parathyroid hormone secretion in postmenopausal women. New England Journal of Medicine 1989; 321: 1777–83.CrossRefGoogle ScholarPubMed
14Chapuy, MC, Preziosi, P, Maamer, M, Arnaud, S, Galan, P, Hercberg, S, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis International 1997; 7: 439–43.CrossRefGoogle Scholar
15Dawson-Hughes, B, Harris, SS, Dallal, GE. Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. American Journal of Clinical Nutrition 1997; 65: 67–71.CrossRefGoogle ScholarPubMed
16McKenna, MJ, Freaney, R. Secondary hyperparathyroidism in the elderly: means to defining hypovitaminosis D. Osteoporosis International 1998; 8: S3–6.CrossRefGoogle ScholarPubMed
17Heaney, RP, Dowell, MS, Hale, CA, Bendich, A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. Journal of the American College of Nutrition 2003; 22: 142–6.CrossRefGoogle ScholarPubMed
18Zittermann, A. Vitamin D in preventive medicine: are we ignoring the evidence?. British Journal of Nutrition 2003; 89: 552–72.CrossRefGoogle ScholarPubMed
19Holick, MF. Vitamin D: importance in the prevention of cancers, type-1 diabetes, heart disease and osteoporosis. American Journal of Clinical Nutrition 2004; 79: 362–71.CrossRefGoogle ScholarPubMed
20Bates, CJ, Carter, GD, Mishra, GD, O'Shea, D, Jones, J, Prentice, A. In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? A study of people aged 65 years and over from the British National Diet and Nutrition Survey. Osteoporosis International 2003; 14: 152–9.CrossRefGoogle Scholar
21Vieth, R, Ladak, Y, Walfish, PG. Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. Journal of Clinical Endocrinology and Metabolism 2003; 88: 185–91.CrossRefGoogle ScholarPubMed
22MacLaughlin, J, Holick, MF. Aging decreases the capacity of human skin to produce vitamin D3. Journal of Clinical Investigation 1985; 76: 1536–8.CrossRefGoogle ScholarPubMed
23Sherman, SS, Hollis, BW, Tobin, JD. Vitamin D status and related parameters in a healthy population: the effects of age, sex and season. Journal of Clinical Endocrinology and Metabolism 1990; 71: 405–13.CrossRefGoogle Scholar
24Harris, SS, Soteriades, E, Coolidge, JA-S, Mudgal, S, Dawson-Hughes, B. Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. Journal of Clinical Endocrinology and Metabolism 2000; 85: 4125–30.Google Scholar
25Arunabh, S, Pollack, S, Yeh, J, Aloia, JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. Journal of Clinical Endocrinology and Metabolism 2003; 88: 157–61.CrossRefGoogle ScholarPubMed
26Burnand, B, Sloutskis, D, Gianoli, F, Cornuz, J, Rickenbach, M, Paccaud, F, et al. Serum 25-hydroxyvitamin D: distribution and determinants in the Swiss population. American Journal of Clinical Nutrition 1992; 56: 537–42.CrossRefGoogle ScholarPubMed
27Parikh, SJ, Edelman, M, Uwaifo, GI, Freedman, RJ, Semega-Janneh, M, Reynolds, J, et al. The relationship between obesity and serum 1,25-dihydroxyvitamin D concentrations in healthy adults. Journal of Clinical Endocrinology and Metabolism 2004; 89: 1196–9.CrossRefGoogle ScholarPubMed
28Brot, C, Jorgensen, NR, Sørensen, OH. The influence of smoking on vitamin D status and calcium metabolism. European Journal of Clinical Nutrition 1999; 53: 920–6.CrossRefGoogle ScholarPubMed
29Kiely, M, Flynn, A, Harrington, KE, Robson, PJ, O'Connor, N, Hannon, EM, et al. The efficacy and safety of nutritional supplement use in a representative sample of adults in the North/South Ireland Food Consumption Survey. Public Health Nutrition 2001; 4: 1089–97.CrossRefGoogle Scholar
30Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington,DC: National Academy Press, 1997.Google Scholar
31Ministry of Agriculture, Fisheries and Food. Food Portion Sizes. London: The Stationery Office, 1997.Google Scholar
32Heaney, RP, Weaver, CM. Calcium and vitamin D. Endocrinology and Metabolism Clinics of North America 2003; 32: 181–94.CrossRefGoogle ScholarPubMed
33Pratt, DA, Daniloff, Y, Duncan, A, Robins, SP. Automated analysis of the pyridinium crosslinks of collagen in tissue and urine using solid-phase extraction and reversed-phase high-performance liquid chromatography. Analytical Biochemistry 1992; 207: 168–75.CrossRefGoogle ScholarPubMed
34Calabresi, E, Lasagni, L, Franceschelli, F, Bartolini, L, Serio, M, Brandi, ML. Use of an internal standard to measure pyridinoline and deoxypyridinoline in urine. Clinical Chemistry 1994; 40: 336–7.CrossRefGoogle ScholarPubMed
35Robins, SP, Stead, DA, Duncan, A. Precautions in using an internal standard to measure pyridinoline and deoxypyridinoline in urine. Clinical Chemistry 1994; 40: 2322–3.CrossRefGoogle ScholarPubMed
36Colwell, A, Russell, RG, Eastell, R. Factors affecting the assay of urinary 3-hydroxypyridinium crosslinks of collagen as markers of bone resorption. European Journal of Clinical Investigation 1993; 23: 341–9.CrossRefGoogle Scholar
37McKenna, M, Freaney, R, Keating, D, Muldowney, FP. The prevalence and management of vitamin D deficiency in an acute geriatric unit. Irish Medical Journal 1981; 74: 336–8.Google Scholar
38McKenna, MJ, Freaney, R, Meade, A, Muldowney, FP. Hypovitaminosis D and elevated serum alkaline phosphatase in elderly Irish people. American Journal of Clinical Nutrition 1985; 41: 101–9.CrossRefGoogle ScholarPubMed
39Meade, A, Moloney, M, O'Keeffe, D. Prevalence of vitamin D deficiency in the elderly in two rural areas in Ireland. Irish Medical Journal 1986; 79: 359.Google ScholarPubMed
40Freaney, R, McBrinn, Y, McKenna, MJ. Secondary hyperparathyroidism in elderly people: combined effect of renal insufficiency and vitamin D deficiency. American Journal of Clinical Nutrition 1993; 58: 187–91.CrossRefGoogle ScholarPubMed
41Andersen, R, Mølgaard, C, Skivgaard, LT, Brot, C, Cashman, KD, Chabros, E, et al. Prevalence of hypovitaminosis D in two risk groups in European countries. European Journal of Clinical Nutrition 2005; 59: 533–41.CrossRefGoogle Scholar
42Dawson-Hughes, B, Heaney, RP, Holick, MF, Lips, P, Meunier, PJ, Vieth, R. Estimates of optimal vitamin D status. Osteoporosis International 2005; 16: 713–6.CrossRefGoogle ScholarPubMed
43Carter, GD, Carter, R, Jones, J, Berry, J. How accurate are assays for 25-hydroxyvitamin D? Data from the international vitamin D external quality assessment scheme. Clinical Chemistry 2004; 50: 2195–7.CrossRefGoogle ScholarPubMed
44Lamberg-Allardt, CJ, Outila, TA, Kärkkäinen, MU, Rita, HJ, Valsta, LM. Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe?. Journal of Bone Mineral Research 2001; 16: 2066–73.CrossRefGoogle ScholarPubMed
45Ilich, JZ, Brownbill, RA, Tamborini, L, Crncevic-Orlic, Z. To drink or not to drink: how are alcohol, caffeine and past smoking related to bone mineral density in elderly women?. Journal of the American College of Nutrition 2002; 21: 536–44.CrossRefGoogle ScholarPubMed
46Scragg, R, Holdaway, I, Jackson, R, Lim, T. Plasma 25–hydroxyvitamin D3 and its relation to physical activity and other heart disease risk factors in the general population. Annals of Epidemiology 1992; 2: 697–703.CrossRefGoogle ScholarPubMed
47Jacques, PF, Felson, DT, Tucker, KL, Mahnken, B, Wilson, PWF, Rosenberg, IH, et al. Plasma 25-hydroxyvitamin D and its determinants in an elderly population sample. American Journal of Clinical Nutrition 1997; 66: 929–36.CrossRefGoogle Scholar
48Liel, Y, Shany, S, Schwartz, B. Interaction between estrogen and vitamin D–endocrine system: a potential addition to the unitary model of osteoporosis. Journal of Bone Mineral Research 1998; 13: 1954–5.CrossRefGoogle Scholar
49Wortsman, J, Matsuoka, LY, Chen, TC, Lu, Z, Holick, MF. Decreased bioavailability of vitamin D in obesity. American Journal of Clinical Nutrition 2000; 72: 690–3.CrossRefGoogle ScholarPubMed
50Need, AG, Morris, HA, Horowitz, M, Nordin, C. Effects of skin thickness, age, body fat, and sunlight on serum 25–hydroxyvitamin D. American Journal of Clinical Nutrition 1993; 58: 882–5.CrossRefGoogle ScholarPubMed
51Holick, MF. Environmental factors that influence the cutaneous production of vitamin D. American Journal of Clinical Nutrition 1995; 61: 638S–45S.CrossRefGoogle ScholarPubMed
52Terenetskaya, I. Two methods for direct assessment of the vitamin D synthetic capacity of sunlight and artificial UV sources. Journal of Steroid Biochemistry and Molecular Biology 2004; 89–90: 623–6.CrossRefGoogle ScholarPubMed
53Kinyamu, HK, Gallagher, JC, Rafferty, KA, Balhorn, KE. Dietary calcium and vitamin D intake in elderly women: effect on serum parathyroid hormone and vitamin D metabolites. American Journal of Clinical Nutrition 1998; 67: 342–8.CrossRefGoogle ScholarPubMed
54Sowers, MR, Wallace, RB, Hollis, BW, Lemke, JH. Parameters related to 25-OH-D levels in a population-based study of women. American Journal of Clinical Nutrition 1986; 43: 621–8.CrossRefGoogle Scholar
55Ooms, ME, Lips, P, Roos, JC, van der Vijgh, WJ, Popp-Snijders, C, Bezemer, PD, et al. Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. Journal of Bone Mineral Research 1995; 10: 1177–84.CrossRefGoogle ScholarPubMed
56Sahota, O, Masud, T, San, P, Hosking, DJ. Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis. Clinical Endocrinology 1999; 51: 217–21.CrossRefGoogle ScholarPubMed
57Mezquita-Raya, P, Munoz-Torres, M, Luna, JD, Luna, V, Lopez-Rodriguez, F, Torres-Vela, E, et al. Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. Journal of Bone Mineral Research 2002; 16: 1408–15.CrossRefGoogle Scholar
58Jesudason, D, Need, AG, Horowitz, M, O'Loughlin, PD, Morris, HA, Nordin, BE. Relationship between serum 25-hydroxyvitamin D and bone resorption markers in vitamin D insufficiency. Bone 2002; 31: 626–30.CrossRefGoogle ScholarPubMed