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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, RJ and Farooq, A and Cherif, A and Hamilton, B and Close, GL and Wilson, MG (2017) 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. British Journal of Sports Medicine. ISSN 1473-0480

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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 'correct' insufficient athletes should not be based on serum 25(OH)D measures.

Item Type: Article
Uncontrolled Keywords: 11 Medical And Health Sciences, 09 Engineering, 13 Education
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: BMJ Publishing Group
Related URLs:
Date Deposited: 14 Nov 2017 14:58
Last Modified: 14 Nov 2017 14:58
DOI or Identification number: 10.1136/bjsports-2016-097130
URI: http://researchonline.ljmu.ac.uk/id/eprint/7552

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