Context: Little is known on the stability of vitamin D status in middle age and whether its tracking patterns associate with bone loss. We evaluated the tracking of serum 25-hydroxyvitamin D (25OHD) measured 6 years apart, and its association with bone mineral density (BMD) in participants of the Busselton Healthy Ageing study aged 46-70 years at baseline.
Methods: Out of the 5017 individuals recruited, 3386 (1871 females) who had serum 25OHD and DXA BMD assessments at both baseline and ~6 years were included in the analysis. The tracking patterns of serum 25OHD were defined as: low/decreasing (both measures <60 nmol/L or moved to lower category over time, n=1103), increasing (moved to higher category over time, n=549), medium (both measures 60-75 nmol/L, n=335) and high (both measures ≥75 nmol/L, n=1399).
Results: Mean season-corrected serum 25OHD was 81.3±22.7 and 78.8±23.1 nmol/L at baseline and 6 years, respectively, and showed moderate correlation (Pearson’s correlation coefficient: 0.568; intraclass correlation coefficient: 0.724). Significant predictors of change in serum 25OHD concentration over 6 years included baseline 25OHD, sex, change in BMI and vitamin D supplement use at follow-up. The high vitamin D status group had significantly higher femoral neck and total hip BMD at baseline than the other three groups (by 0.011-0.018 g/cm2). The low/decreasing vitamin D status group had significantly greater decline in femoral neck and total hip BMD (by 0.005-0.008 g/cm2) over the follow-up period compared with the increasing, medium and high vitamin D status groups after adjustment for sex and baseline BMD values, age, BMI, vitamin D supplement and lifestyle factors (all P<0.05) (Table 1).
Conclusion: Serum 25OHD measured 6 years apart showed moderate tracking. Individuals with consistently low or declining vitamin D status had greater bone loss during the follow-up period and could be the target for intervention.