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Clinical Trial
. 2012;7(7):e40090.
doi: 10.1371/journal.pone.0040090. Epub 2012 Jul 2.

Vitamin D is a major determinant of bone mineral density at school age

Minna Pekkinen  1 , Heli Viljakainen, Elisa Saarnio, Christel Lamberg-Allardt, Outi Mäkitie
Affiliations
Clinical Trial

Vitamin D is a major determinant of bone mineral density at school age

Minna Pekkinen et al. PLoS One. 2012.

Abstract

Background: Vitamin D insufficiency in children may have long-term skeletal consequences as vitamin D affects calcium absorption, bone mineralization and bone mass attainment.

Methodology/principal findings: This school-based study investigated vitamin D status and its association with vitamin D intake and bone health in 195 Finnish children and adolescents (age range 7-19 years). Clinical characteristics, physical activity and dietary vitamin D intake were evaluated. Blood and urine samples were collected for serum 25-hydroxyvitamin D (25-OHD) and other parameters of calcium homeostasis. Bone mineral density (BMD) and body composition were measured with dual-energy X-ray absorptiometry (DXA). Altogether 71% of the subjects were vitamin D insufficient (25-OHD <50 nmol/L). The median 25-OHD was 41 nmol/L for girls and 45 nmol/L for boys, and the respective median vitamin D intakes 9.1 µg/day and 10 µg/day. In regression analysis, after adjusting for relevant factors, 25-OHD concentration explained 5.6% of the variance in lumbar BMD; 25-OHD and exercise together explained 7.6% of the variance in total hip BMD and 17% of the variance in whole body BMD. S-25-OHD was an independent determinant of lumbar spine and whole body BMD and in magnitude surpassed the effects of physical activity.

Conclusions/significance: Vitamin D insufficiency was common even when vitamin D intake exceeded the recommended daily intake. Vitamin D status was a key determinant of BMD. The findings suggest urgent need to increase vitamin D intake to optimize bone health in children.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Association between vitamin D intake and serum 25-OHD concentration.
Figure 2
Figure 2. Association of serum 25-OHD, PTH concentration, and calcium intake.
Calcium intake in tertiles is marked with colors: <800 mg/day (green circles), 800–1200 mg/day (red circles) and >1200 mg/day (black circles), Pearson correlations between S-25-OHD and PTH r = −0.563, p = 0.09; r = −0.054, p = 0.772, r = −0.248, p = 0.017 respectively. The PTH reference line is marked with the broken line.
Figure 3
Figure 3. Association between vitamin D status and physical activity on bone mineral density (BMD).
Correlations between serum 25-OHD concentrations and lumbar spine (A), total hip (B), and whole body (C) bone mineral density (BMD) Z-scores, adjusted for age and gender. Correlations between physical activity and lumbar spine (D), total hip (E), and whole body (F) BMD Z-scores, adjusted for age and gender. Physical activity scores of 13.5, 17 and 20 correspond to 1, 1.5 and 2 h daily activity.
See this image and copyright information in PMC

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