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Determinants of bone mineral density in young Australian women; results from the Safe-D study

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An Erratum to this article was published on 06 September 2017

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Abstract

Summary

The study aimed to explore determinants of bone parameters in young women. Most bone parameters were associated with height and lean mass. Bone parameters were not associated with vitamin D status. Future research should address whether interventions aimed at improving lean mass are beneficial to bone health in young women.

Introduction

The implementation of prevention strategies during young adulthood may be crucial for osteoporosis prevention in later life, yet literature examining the determinants of bone health in premenopausal women is limited. We aimed to assess determinants of bone health, including serum 25-hydroxyvitamin D (25OHD), in females aged 16–25 years, living in Victoria, Australia, recruited through Facebook advertising.

Methods

Serum 25OHD was measured by liquid chromatography-tandem mass spectrometry and bone health was measured using dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) in 326 participants.

Results

Mean (± standard deviation) serum 25OHD was 69 ± 28 nmol/L and the prevalence of vitamin D deficiency (serum 25OHD <50 nmol/L) was 26%. Seven percent of participants (n = 23) reported taking a vitamin D supplement. Two percent of participants had low lumbar spine bone mineral density (Z-score <−2.0), 5% at the hip and 7% at the femoral neck. Serum 25OHD levels were not associated with DXA bone parameters, nor with pQCT bone parameters. Most bone parameters were positively associated with height and lean mass.

Conclusion

Vitamin D status was not associated with bone health in young women in the current study. Our findings suggest that targeting other modifiable factors, such as lean body mass, is likely to be beneficial to bone health in young women. Longitudinal studies examining the association between vitamin D status and bone health in young women are necessary to confirm our findings. In addition, whether raising 25OHD levels is advantageous for young women’s bone health is yet to be determined.

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Change history

  • 06 September 2017

    An erratum to this article has been published.

References

  1. Bonjour J-P, Chevalley T, Ferrari S, Rizzoli R (2009) The importance and relevance of peak bone mass in the prevalence of osteoporosis. Salud Publica de Mexico 51:s5–s17

    Article  PubMed  Google Scholar 

  2. Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936

    Article  PubMed  Google Scholar 

  3. Reginster J-Y, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38:4–9

    Article  Google Scholar 

  4. International Osteoporosis Foundation (2015) The global burden of osteoporosis: a factsheet. https://Iofbonehealthorg/Sites/Default/Files/Media/PDFs/Fact%20Sheets/2014-Factsheet-Osteoporosis-A4pdf Accessed (6 June 2016)

  5. DeLuca HF (2004) Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 80:1689S–1696S

    CAS  PubMed  Google Scholar 

  6. Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography–tandem mass spectrometry in the US population during 2007–2010. J Nutr 146:1051–1061

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Mithal A, Wahl D, Bonjour J-P, Burckhardt P, Dawson-Hughes B, Eisman J, Fuleihan GE-H, Josse R, Lips P, Morales-Torres J (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820

    Article  CAS  PubMed  Google Scholar 

  8. Palacios C, Gonzalez L (2014) Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 144:138–145

    Article  CAS  PubMed  Google Scholar 

  9. Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B (2004) Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J med 116:634–639

    Article  CAS  PubMed  Google Scholar 

  10. Hwang S, Choi H, Kim K, Rhee Y, Lim S (2015) Associations between serum 25-hydroxyvitamin D and bone mineral density and proximal femur geometry in Koreans: the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2009. Osteoporos Int 26:163–171

    Article  CAS  PubMed  Google Scholar 

  11. Malabanan A, Veronikis I, Holick M (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  CAS  PubMed  Google Scholar 

  12. Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C, Streichert T (2010) Bone mineralization defects and vitamin D deficiency: Histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner res 25:305–312

    Article  CAS  PubMed  Google Scholar 

  13. Christie JJ, Nowson CA, Garland SM, Wark JD (2013) Emerging nutritional and lifestyle risk factors for bone health in young women: a mixed longitudinal twin study. Nutritional Influences on Bone Health. Springer, pp 61-69

  14. Hopper JL, Seeman E (1994) The bone density of female twins discordant for tobacco use. N Engl J med 330:387–392

    Article  CAS  PubMed  Google Scholar 

  15. Cranney A (2007) Effectiveness and safety of vitamin D in relation to bone health. Evidence report/technology assessment 1

  16. Weaver C, Gordon C, Janz K, Kalkwarf H, Lappe J, Lewis R, O’Karma M, Wallace T, Zemel B (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporosis international 1-106

  17. Callegari ET, Reavley N, Garland SM, Gorelik A, Wark JD (2015) Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study. Journal of Public Health Research 4:152–156

    Article  Google Scholar 

  18. Giles G, Ireland P (1996) Dietary questionnaire for epidemiological studies (version 2). Cancer Council Victoria, Melbourne

    Google Scholar 

  19. Brown WJ, Burton NW, Marshall AL, Miller YD (2008) Reliability and validity of a modified self-administered version of the Active Australia physical activity survey in a sample of mid-age women. Aust N Z J Public Health 32:535–541

    Article  PubMed  Google Scholar 

  20. Beasley JM, Ichikawa LE, Ange BA, Spangler L, LaCroix AZ, Ott SM, Scholes D (2010) Is protein intake associated with bone mineral density in young women? Am J Clin Nutr 91:1311–1316

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Cohen J (1990) Things I have learned (so far). Am Psychol 45:1304

    Article  Google Scholar 

  22. Boot AM, Krenning EP, de Muinck Keizer-Schrama SM (2011) The relation between 25-hydroxyvitamin D with peak bone mineral density and body composition in healthy young adults. J Pediatr Endocrinol Metab 24:355–360

    Article  CAS  PubMed  Google Scholar 

  23. Tønnesen R, Schwarz P, Hovind PH, Jensen LT (2016) Physical exercise associated with improved BMD independently of sex and vitamin D levels in young adults. European Journal of Applied Physiology 1-8

  24. Adami S, Bertoldo F, Braga V, Fracassi E, Gatti D, Gandolini G, Minisola S, Battista Rini G (2009) 25-hydroxy vitamin D levels in healthy premenopausal women: association with bone turnover markers and bone mineral density. Bone 45:423–426

    Article  CAS  PubMed  Google Scholar 

  25. Fujiyoshi A, Polgreen LE, Hurley DL, Gross MD, Sidney S, Jacobs DR Jr (2013) A cross-sectional association between bone mineral density and parathyroid hormone and other biomarkers in community-dwelling young adults: the CARDIA study. The Journal of Clinical Endocrinology & Metabolism 98:4038–4046

    Article  CAS  Google Scholar 

  26. Walker MD, Nishiyama KK, Zhou B, Cong E, Wang J, Lee JA, Kepley A, Zhang C, Guo XE, Silverberg SJ (2016) Effect of low vitamin D on volumetric bone mineral density, bone microarchitecture, and stiffness in primary hyperparathyroidism. The Journal of Clinical Endocrinology & Metabolism 101:905–913

    Article  CAS  Google Scholar 

  27. Sayers A, Fraser W, Lawlor D, Tobias J (2012) 25-Hydroxyvitamin-D3 levels are positively related to subsequent cortical bone development in childhood: findings from a large prospective cohort study. Osteoporos Int 23:2117–2128

    Article  CAS  PubMed  Google Scholar 

  28. Mosele M, Coin A, Manzato E, Sarti S, Berton L, Bolzetta F, Imoscopi A, Rinaldi G, Perissinotto E, Sergi G (2013) Association between serum 25-hydroxyvitamin D levels, bone geometry, and bone mineral density in healthy older adults. J Gerontol Ser a Biol med Sci 68:992–998

    Article  CAS  Google Scholar 

  29. Callegari ET, Gorelik A, Garland SM, Chiang CY, Wark JD (2016) Bone turnover marker reference intervals in young females. Ann Clin Biochem 0:0004563216665123

  30. World Health Organization (2016) Physical inactivity: a global public health problem. http://Wwwwhoint/Dietphysicalactivity/factsheet_inactivity/en/ Accessed (22 November 2016)

  31. Young D, Hopper JL, Nowson CA, Green RM, Sherwin JA, Kaymakci B, Smid M, Guest CS, Larkins RG, Wark JD (1995) Determinants of bone mass in 10- to 26-year-old females: a twin study. J Bone Miner res 10:558–567

    Article  CAS  PubMed  Google Scholar 

  32. Hopper JL, Green RM, Nowson CA, Young D, Sherwin AJ, Kaymakci B, Larkins RG, Wark JD (1998) Genetic, common environment, and individual specific components of variance for bone mineral density in 10-to 26-year-old females: a twin study. Am J Epidemiol 147:17–29

    Article  CAS  PubMed  Google Scholar 

  33. Kelley GA, Kelley KS (2013) Kohrt WM (2013) exercise and bone mineral density in premenopausal women: a meta-analysis of randomized controlled trials. Int J Endocrinol

  34. Chouinard LE, Randall Simpson J, Buchholz AC (2012) Predictors of bone mineral density in a convenience sample of young Caucasian adults living in southern Ontario. Appl Physiol Nutr Metab 37:706–714

    Article  CAS  PubMed  Google Scholar 

  35. Khan K, Bennell K, Hopper J, Flicker L, Nowson C, Sherwin A, Crichton K, Harcourt P, Wark J (1998) Self-reported ballet classes undertaken at age 10–12 years and hip bone mineral density in later life. Osteoporos Int 8:165–173

    Article  CAS  PubMed  Google Scholar 

  36. Recker RR, Davies KM, Hinders SM, Heaney RP, Stegman MR, Kimmel DB (1992) Bone gain in young adult women. JAMA 268:2403–2408

    Article  CAS  PubMed  Google Scholar 

  37. Australian Bureau of Statistics (2016) Migration, Australia, 2014–15: Overseas Born Aussies Highest in over a Century http://Wwwabsgovau/Ausstats/abs@Nsf/Lookup/34120Media%20Release12014-15 Accessed 18 November 2016

  38. Eisman JA (1999) Genetics of osteoporosis. Endocr rev 20:788–804

    Article  CAS  PubMed  Google Scholar 

  39. Nowson C, Green R, Hopper J, Sherwin A, Young D, Kaymakci B, Guest C, Smid M, Larkins R, Wark J (1997) A co-twin study of the effect of calcium supplementation on bone density during adolescence. Osteoporos Int 7:219–225

    Article  CAS  PubMed  Google Scholar 

  40. Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, Gunasekaran B, Wark JD (2012) Web-based recruiting for health research using a social networking site: an exploratory study. Journal of Medical Internet Research:14

  41. Macgregor S, Cornes BK, Martin NG, Visscher PM (2006) Bias, precision and heritability of self-reported and clinically measured height in Australian twins. Hum Genet 120:571–580

    Article  PubMed  Google Scholar 

  42. Grober U, Spitz J, Reichrath J, Kisters K, Holick M (2013) Vitamin D: update 2013: from rickets prophylaxis to general preventive healthcare. Dermatoendocrinol 5:331–347

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors thank the participants who took part in the Safe-D study. The authors also thank the Safe-D chief investigators Dr. Nicola Reavley, A/Professor Marie Pirotta, Prof George Varigos, A/Prof Shanton Chang, and as well as associate investigators Prof Kim Bennell, Prof Anthony Jorm, and past study coordinator Ms. Adele Rivers. The authors also thank the Young Female Health Initiative (YFHI) associate investigators Dr. Yasmin Jayasinghe, Dr. Catherine Segan, and Dr. Asvini Subasinghe. The authors thank Anna Scobie, Marjan Tabesh, Miaowen Zhou, Lauren Gilbert, and Skye Maclean for assisting with the Safe-D study. We acknowledge the following people for their help with various components of the study: Adrian Bickerstaffe (The University of Melbourne); Maria Bisignano (Melbourne Health Shared Pathology Service); Dr. Ashwini Kale (The University of Melbourne); Dr. Johannes Willnecker (Novotec Medical GmbH). The Safe-D study was funded by National Health and Medical Research Council (NHMRC) project grant APP1049065.

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Correspondence to J. D. Wark.

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Conflicts of interest

The Safe-D study (part B) has received in-kind support from Swisse Wellness. Swisse Wellness did not play a role in study design, the implementation of these studies, nor the interpretation of the findings.

Additional information

An erratum to this article is available at https://doi.org/10.1007/s00198-017-4210-1.

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Callegari, E.T., Garland, S.M., Gorelik, A. et al. Determinants of bone mineral density in young Australian women; results from the Safe-D study. Osteoporos Int 28, 2619–2631 (2017). https://doi.org/10.1007/s00198-017-4100-6

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