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American Journal of Clinical Nutrition, Vol. 87, No. 4, 1039-1044, April 2008
© 2008 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Low vitamin D status adversely affects bone health parameters in adolescents1,2,3

Kevin D Cashman, Tom R Hill, Alice A Cotter, Colin A Boreham, Werner Dubitzky, Liam Murray, JJ Strain, Albert Flynn, Paula J Robson, Julie MW Wallace and Mairead Kiely

1 From the Departments of Food and Nutritional Sciences (TRH, AAC, AF, MK, and KDC) and Medicine (KDC), University College, Cork, Ireland; the Northern Ireland Centre for Food and Health (JW, PR, and JJS) and the Systems Biology Research Group (WD), University of Ulster, Coleraine, United Kingdom; the University College Dublin Institute for Sport and Health, University College, Dublin, Ireland (CB), and the Department of Epidemiology and Public Health, Queens University, Belfast, United Kingdom (LM)

Background: The effects of subclinical vitamin D deficiency on bone mineral density (BMD) and bone turnover in adolescents, especially in boys, are unclear.

Objective: We aimed to investigate the relations of different stages of vitamin D status and BMD and bone turnover in a representative sample of adolescent boys and girls.

Design: BMD was measured by dual-energy X-ray absorptiometry at the nondominant forearm and dominant heel in a random sample of 12- (n = 260) and 15-y-old (n = 239) boys and 12- (n = 266) and 15-y-old (n = 250) girls. Serum 25-hydroxyvitamin D, parathyroid hormone, osteocalcin, and type I collagen cross-linked C-telopeptide were assessed by using enzyme-linked immunoassays. Relations between vitamin D status and bone health indexes were assessed by using regression modeling.

Results: Using multivariate regression to adjust for potential physical, lifestyle, and dietary confounding factors, we observed that 12- and 15-y-old girls with high vitamin D status (≥74.1 nmol/L) had significantly greater forearm (but not heel) BMD (β = 0.018; SE = 0.008; P < 0.05 for each age group) and lower serum parathyroid hormone concentrations and bone turnover markers than did those with low vitamin D status. These associations were evident in subjects sampled throughout the year and in winter only. There was no significant relation between vitamin D status and BMD in boys.

Conclusions: Maintaining serum 25-hydroxyvitamin D concentrations above {approx}50 nmol/L throughout the year may be a cost-effective means of improving bone health. Increased emphasis on exploring strategies for improving vitamin D status in adolescents is needed.






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