High Serum 25-hydroxyvitamin D is Associated with Low Incidence of Stress Fractures
Abstract
Low serum 25-hydroxyvitamin D [25(OH)D] levels cause rickets and osteomalacia, but it is unknown whether the condition increases risk of stress fractures in young adult. This study was conducted to determine if young women with low serum 25(OH)D have an increased risk of stress fracture compared to those at higher levels. Methods. The Department of Defense has collected and frozen serum from over nine million service members. Pre-fracture serum specimens from 600 female cases of stress fracture of the tibia or fibula that occurred during the first 180 days of active-duty were analyzed for 25(OH)D content. Specimens from 600 controls, individually matched to the cases on age (+/-2 years);race (white, black or other); length of service +/- 30 days; who had blood drawn within 2 days of the case; and were on active duty within 30 days of the case?s diagnosis also were analyzed. Findings: Higher serum 25(OH)D levels were associated with lower risk of stress fracture (p =0..02). A linear dose-response relationship with increasing serum 25(OH)D revealed 50% lower risk of stress fracture in the top compared to the bottom quintile (p trend = 0.02). Women in the lowest quintile (≤ 19.7 ng/ml) had a mean 25(OH)D of 13.9 ng/ml (standard deviation [SD] +/-4.0), while those in the highest ≥ 39.9 had a mean of 49.7 ng/ml (SD +/- 10.4 ng/ml). Interpretation. Lower incidence of stress fracture in women with serum 25(OH)D greater than approximately 40 ng/ml indicates a minimum clinical target for prevention.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2011
- Accession Number
- ADA562593
Entities
People
- Alina A. Burgi
- Cedric F. Garland
- Edward Doerr Gorham
- Frank C. Garland
- Joan M. Lappe
- Kenneth Zeng
- Kerry Thompson
- Sharif B. Mohr
Organizations
- Naval Health Research Center