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
. 2025 Dec 5;15(1):43213.
doi: 10.1038/s41598-025-27321-1.

Associations of bone health biomarkers and bone mineral density with dietary intakes in vitamin D deficient women: a cross-sectional study

Chandni Halcyon Peris #  1   2 , Sumithra Selvam #  3 , Sumathi Swaminathan #  2 , Ravi Rangarajan #  4 , Tony Raj #  5   6 , Prashanth Thankachan #  7
Affiliations

Associations of bone health biomarkers and bone mineral density with dietary intakes in vitamin D deficient women: a cross-sectional study

Chandni Halcyon Peris et al. Sci Rep. .

Abstract

Vitamin D, an essential nutrient for bone health, is widely deficient in India despite abundant sunlight. The prevalence ranges between 70 and 90% in adult women. We studied the prevalence of vitamin D deficiency/insufficiency and the association between serum 25-hydroxyvitamin D, parathyroid hormone, osteocalcin, bone-specific alkaline phosphatase, bone mineral density, and dietary intakes in young urban women. Among 220 women screened, 84.7% of participants had suboptimal vitamin D (64.5% deficient 20.2% insufficient). In 108 vitamin D deficient women, 75% reported below 15 min of daily sun exposure. Dietary calcium intake was 480.6 ± 117.7 mg/day. Serum 25(OH)D was negatively correlated with PTH (⍴ = - 0.364, p < 0.001) and osteocalcin (⍴ = - 0.342, p < 0.001). Osteocalcin was positively correlated with dietary calcium (⍴ = 0.228, p < 0.01), Ca: P (⍴ = 0.240, p < 0.01) and milk intake (⍴ = 0.226, p < 0.01). Positive associations were observed between osteocalcin and Ca: P ratio [β = 23.58, 95% CI: -0.614 to 47.771, p = 0.056] and with milk intake [β = 0.03, 95% CI: -0.001 to 0.065, p = 0.058]. The coexistence of vitamin D deficiency with inadequate calcium intake, and limited sun exposure, underscores the importance of strategies to promote calcium-rich diets and adequate sunlight practices to support bone health.

Keywords: Bone Biomarkers; Bone Mineral Density; Calcium; Osteocalcin; Sun Exposure; Vitamin D Deficiency.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study adhered to the principles outlined in the Declaration of Helsinki, with approval from the Institutional Review Board (IRB) of St. John’s Medical College and Hospital, Bangalore, India (protocol code IEC Study Ref No: 370/2018; date of approval: 7 January 2019), for all procedures involving participants. Written informed consent was obtained from all individuals involved in the study.

Figures

Fig. 1
Fig. 1
Correlation between serum osteocalcin levels and dietary variables among vitamin D-deficient and vitamin D-insufficient women. (A) Correlation between usual dietary calcium intake (mg/day) and serum osteocalcin levels (ng/mL). (B) Correlation between usual dietary calcium-to-phosphorus (Ca: P) intake ratio and serum osteocalcin levels (ng/mL). (C) Correlation between usual dairy (milk and milk product) intake (mL/day) and serum osteocalcin levels (ng/mL). Each dot represents one participant (n = 106). Red dashed lines indicate linear regression fits. Ca: P calcium-to-phosphorus ratio.
See this image and copyright information in PMC

References

    1. Holick, M. F. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev. Endocr. Metab. Disord. 18, 153–165 (2017). - DOI - PubMed
    1. Amrein, K. et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur. J. Clin. Nutr.74, 1498–1513. 10.1038/s41430-020-0558-y (2020). - DOI - PMC - PubMed
    1. Siddiqee, M. H., Bhattacharjee, B., Siddiqi, U. R. & Rahman, M. M. High prevalence of vitamin D deficiency among South Asian adults: a systematic review and meta-analysis. BMC Public. Health. 21, 1823 (2021). - DOI - PMC - PubMed
    1. Aparna, P., Muthathal, S., Nongkynrih, B. & Gupta, S. Vitamin D deficiency in India. J. Family Med. Prim. Care. 7, 324–330. 10.4103/jfmpc.jfmpc_78_18 (2018). - DOI - PMC - PubMed
    1. Janoušek, J. et al. Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit. Rev. Clin. Lab. Sci.59, 517–554 (2022). - DOI - PubMed

LinkOut - more resources