Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May;100(5):2046-54.
doi: 10.1210/jc.2014-4367. Epub 2015 Feb 26.

Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause

Jane A Cauley  1 , Gail A Greendale, Kristine Ruppert, Yinjuan Lian, John F Randolph Jr, Joan C Lo, Sherri-Ann Burnett-Bowie, Joel S Finkelstein
Affiliations

Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause

Jane A Cauley et al. J Clin Endocrinol Metab. 2015 May.

Abstract

Context: Low levels of serum 25 Hydroxyvitamin D [25(OH)D] have been linked to greater fracture risk in older women.

Objective: This study aimed to determine whether higher 25(OH)D is associated with slower loss of bone mineral density (BMD) and lower fracture risk during the menopausal transition.

Design, setting, and participants: This was a prospective cohort study at five clinical centers in the United States. Mean age was 48.5 ± 2.7 years. The fracture analysis included 124 women with an incident traumatic fracture, 88 with incident nontraumatic fracture, and 1532 women without incident fractures; average followup was 9.5 years. BMD analysis included 922 women with a documented final menstrual period.

Main outcome measures: Serum 25(OH)D was measured by liquid chromatography tandem mass spectrometry at the third annual clinic visit. BMD was measured and incident fractures ascertained at each annual visit.

Results: The mean 25(OH)D was 21.8 ng/mL; seven-hundred two (43%) of the women had 25(OH)D values <20 ng/mL. There was no significant association between 25(OH)D and traumatic fractures. In multivariate adjusted hazards models, the hazard ratio (HR) for nontraumatic fractures (95% confidence interval [CI]) was 0.72 (0.54-0.96) for each 10-ng/mL increase in 25(OH)D. Comparing women whose 25(OH)D was ≥20 vs <20 ng/mL, the HR (95% CI) for fracture was 0.54 (0.32-0.89). Changes in lumbar spine and femoral neck bone mineral density across menopause were not significantly associated with serum 25(OH)D level.

Conclusion: Serum 25(OH)D levels are inversely associated with nontraumatic fracture in mid-life women. Vitamin D supplementation is warranted in midlife women with 25(OH)D levels <20 ng/mL.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative hazard of nontraumatic fractures by 25(OH)D: < 20 ng/mL vs ≥ 20 ng/mL.
Figure 2.
Figure 2.
Cubic spline graph: 25(OH)D and nontraumatic fractures over the full range of 25(OH)D.
See this image and copyright information in PMC

References

    1. Heaney RP, Recker RR, Saville PD. Menopausal changes in calcium balance performance. J Lab Clin Med. 1978;92:953–963. - PubMed
    1. Cauley JA, Parimi N, Ensrud KE, et al. Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men. J Bone Miner Res. 2010;25:545–553. - PMC - PubMed
    1. Cauley JA, Danielson ME, Boudreau R, et al. Serum 25-hydroxyvitamin D and clinical fracture risk in a multiethnic cohort of women: The Women's Health Initiative (WHI). J Bone Miner Res. 2011;26:2378–2388. - PMC - PubMed
    1. van Schoor NM, Visser M, Pluijm SM, et al. Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone. 2008;42:260–266. - PubMed
    1. Nakamura K, Saito T, Oyama M, et al. Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: The Muramatsu study. Osteoporos Int. 2011;22:97–103. - PubMed

Publication types

LinkOut - more resources