Effect of isolated vitamin D supplementation on bone turnover markers in younger postmenopausal women: a randomized, double-blind, placebo-controlled trial
- 254 Downloads
Vitamin D (VD) plays an important role in bone mineralization. The present study investigates the effect of VD supplementation alone on bone turnover markers in younger postmenopausal women. It has been shown that VD supplementation in postmenopausal women with hypovitaminosis D is associated with a reduction in bone turnover markers.
The purpose of this study is to evaluate the effect of VD supplementation alone on bone turnover markers in younger postmenopausal women.
In this double-blind, placebo-controlled trial, 160 women were randomized into the VD group (supplementation with 1000 IU of vitamin D3/day, orally; n = 80) or placebo group (n = 80). Women aged 50–65 years with amenorrhea ≥ 12 months and normal bone mineral density were included. The intervention lasted 9 months, and the participants were assessed at the beginning and end of treatment. Serum levels of total calcium, parathormone (PTH), alkaline phosphatase (AP), and 24-h urine calcium were determined. Serum C-terminal telopeptide of type I collagen (s-CTX) and procollagen type 1 N-terminal propeptide (P1NP) were measured by immunoassay as markers of bone resorption and formation, respectively. Plasma 25-hydroxyvitamin-D [25(OH)D] concentrations were measured by HPLC. Intention-to-treat analysis was performed using ANOVA, Student’s t test, Tukey’s test, and gamma distribution.
Over the period of 9 months, 25(OH)D concentrations increased from 15.0 ± 7.5 to 27.5 ± 10.4 ng/mL (+ 45.4%) in the VD group and decreased from 16.9 ± 6.7 to 13.8 ± 6.0 ng/mL (− 18.5%) in the placebo group (p < 0.001). There was a decrease (− 21.3%) of PTH levels in the VD group with a significant difference between groups at the end of the study (p < 0.001). No significant differences were observed in the other laboratory parameters (total calcium, AP, and calciuria) in either group (p > 0.05). A comparison of bone turnover markers showed a significant reduction in of s-CTX (− 24.2%, p < .0001) and P1NP (− 13.4%, p = 0.003) levels in the VD group. No significant variations in bone turnover markers were observed in the placebo group (s-CTX, − 6.9%, p = 0.092 and P1NP, − 0.6%, p = 0.918).
In younger postmenopausal women with VD deficiency, isolated supplementation with 1000 IU of vitamin D3 for 9 months is associated with a reduction in bone turnover markers. However, any between-group differences was not observed in bone turnover markers.
KeywordsBone turnover Menopause Vitamin D
This work was supported by grants from the São Paulo Research Foundation (FAPESP) process number 2014/00001-0.
Compliance with ethical standards
Informed consent was obtained from all participants, and the study was approved by the Research Ethics Committee of the Botucatu Medical School, UNESP.
Conflicts of interest
- 1.Cavalier E, Bergmann P, Bruyère O, Delanaye P, Durnez A, Devogelaer JP, Ferrari SL, Gielen E, Goemaere S, Kaufman JM, Toukap AN, Reginster JY, Rousseau AF, Rozenberg S, Scheen AJ, Body JJ (2016) The role of biochemical of bone turnover markers in osteoporosis and metabolic bone disease: a consensus paper of the Belgian Bone Club. Osteoporos Int 27:2181–2195CrossRefPubMedGoogle Scholar
- 14.Wimalawansa SJ, Razzaque DMS, Al-Daghri NM (2017) Calcium and vitamin D in human health: hype or real? J Steroid Biochem Mol Biol. https://doi.org/10.1016/j.jsbmb.2017.12.009
- 16.Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Manson JE, Mayne ST, Ross AC, Shapses SA, Taylor CL (2012) IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97:1146–1152CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Schwetz V, Trummer C, Pandis M, Grübler MR, Verheyen N, Gaksch M, Zittermann A, März W, Aberer F, Lang A, Treiber G, Friedl C, Obermayer-Pietsch B, Pieber TR, Tomaschitz A, Pilz S (2017) Effects of vitamin D supplementation on bone turnover markers: a randomized controlled trial. Nutrients. https://doi.org/10.3390/nu9050432
- 21.EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2016) Scientific opinion on dietary reference values for vitamin D. EFSA J 14:4547Google Scholar
- 22.Madar AA, Knutsen KV, Stene LC, Brekke M, Lagerløv P, Meyer HE, Macdonald HM (2015) Effect of vitamin D3-supplementation on bone markers (serumP1NP and CTX): a randomized, double blinded, placebo controlled trial among healthy immigrants living in Norway. Bone Reports 2:82–88CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Cangussu LM, Nahas-Neto J, Orsatti CL, Poloni PF, Schmitt EB, Almeida-Filho B, Nahas EAP (2016) Effect of isolated vitamin D supplementation on the rate of falls and postural balance in postmenopausal women fallers: a randomized, double-blind, placebo-controlled trial. Menopause 23:267–274CrossRefPubMedGoogle Scholar
- 28.Executive Summary of the Third report of the National Cholesterol Education Program (NCEP) (2002) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 106:3143–3421Google Scholar
- 31.Glover SJ, Gall M, Schoenborn-Kellenberger O, Wagener M, Garnero P, Boonen S, Cauley JA, Black DM, Delmas PD, Eastell R (2009) Establishing a reference interval for bone turnover markers in 637 healthy, young, premenopausal women from the United Kingdom, France, Belgium, and the United States. J Bone Miner Res 24:389–397CrossRefPubMedGoogle Scholar
- 32.Grados F, Brazier M, Kamel S, Mathieu M, Hurtebize N, Maamer M, Garabédian M, Sebert JL, Fardellone P (2003) Prediction of bone mass density variation by bone remodeling markers in postmenopausal women with vitamin D insufficiency treated with calcium and vitamin D supplementation. J Clin Endocrinol Metab 88:5175–5179CrossRefPubMedGoogle Scholar
- 41.Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, McClung M, Morris HA, Silverman S, Trenti T, Wahl DA, Cooper C, Kanis JA, IOF-IFCC Bone Marker Standards Working Group (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22:391–420CrossRefPubMedGoogle Scholar