Vitamin D status and sex hormone binding globulin: Determinants of bone turnover and bone mineral density in elderly women
Article first published online: 3 DEC 2009
Copyright © 1995 ASBMR
Journal of Bone and Mineral Research
Volume 10, Issue 8, pages 1177–1184, August 1995
How to Cite
Ooms, M. E., Lips, P., Roos, J. C., van der Vijgh, W. J. F., Popp-Snijders, C., Bezemer, P. D. and Bouter, L. M. (1995), Vitamin D status and sex hormone binding globulin: Determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res, 10: 1177–1184. doi: 10.1002/jbmr.5650100806
- Issue published online: 3 DEC 2009
- Article first published online: 3 DEC 2009
- Manuscript Accepted: 6 APR 1995
- Manuscript Revised: 8 MAR 1995
- Manuscript Received: 22 SEP 1994
- Praeventiefonds, The Hague, The Netherlands. Grant Number: 28-1112-1.
To examine the relation of the vitamin D status and the remaining estrogen activity with bone turnover and bone mineral density (BMD) in elderly women, BMD was measured at both hips using dual-energy X-ray absorptiometry and at the distal radius using single photon absorptiometry, in 330 healthy women aged 70 and over. Vitamin D metabolites, sex hormone binding globulin (SHBG), PTH(1–84), osteocalcin, alkaline phosphatase, and hydroxyproline and calcium excretion in 2 h fasting urine were measured. Multiple linear regression was used to adjust for potential confounders. In 65% of the women, serum 25(OH)D was below 30 nmol/l. Only values below a threshold for 25(OH)D were negatively related to serum PTH(1–84) (p = 0.02, threshold at 25 nmol/l) and to osteocalcin levels (p = 0.04, threshold at 30 nmol/l). BMD of the femoral neck and trochanter was positively related to serum 25(OH)D (left neck p = 0.001) with thresholds at 30 nmol/l whereas the distal radius was not (p = 0.32). Serum PTH was negatively related to BMD at all measurement sites (all p < 0.001). Serum SHBG, an inverse measure of estrogen activity, was positively related to osteocalcin levels (p = 0.004) and the urinary hydroxyproline/creatinine ratio (p = 0.002) and negatively related to the BMD of the trochanter (left trochanter p = 0.02) and the distal radius (p = 0.001). We conclude that in elderly women, serum 25(OH)D levels below 30 nmol/l are associated with secondary hyperparathyroidism and increased bone turnover. SHBG is positively related to bone turnover. Vitamin D deficiency especially influences BMD of the femoral neck, a cortical area. SHBG mainly influences BMD at the trochanteric region and distal radius, predominantly trabecular areas, which may reflect the effects of remaining estrogen activity.