학술논문
Intra-trial Mean 25(OH)D and PTH Levels and Risk of Falling in Older Men and Women in the Boston STOP IT Trial
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Source
Journal of Clinical Endocrinology & Metabolism. May 2022, Vol. 107 Issue 5, p1932, 6 p.
Subject
Language
English
ISSN
0021-972X
Abstract
In observational studies in older adults (1), low circulating levels of 25-hydroxyvitamin D [25(OH)D] have been associated with increased risk of falling, but the evidence that supplementation with vitamin D [...]
Context: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. Objective: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in healthy older adults. Design: Observational within a clinical trial. Setting: The Bone Metabolism Laboratory at the USDA Nutrition Center at Tufts University. Participants: 410 men and women age [greater than or equal to]65 years who participated in the 3-year Boston STOP IT trial to determine the effect of supplementation with 700 IU of vitamin [D.sub.3] plus calcium on incident falls (secondary endpoint). Intra-trial exposures of 25(OH)D and PTH were calculated as the mean of biannual measures up to and including the first fall. Main outcome measures: Incidence of first fall. Results: Intra-trial mean 25(OH)D was significantly associated with risk of falling in a U-shaped pattern; the range associated with minimal risk of falling was approximately 20 to 40 ng/mL. PTH was not significantly associated with risk of falling. Conclusions: The findings highlight the importance of maintaining the circulating 25(OH)D level between 20 and 40 ng/mL, the range that is also recommended for bone health. At PTH levels within the normal range, there was no detectible independent association of PTH with fall risk. Key Words: 25(OH)D, PTH, falls, vitamin D supplementation
Context: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. Objective: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in healthy older adults. Design: Observational within a clinical trial. Setting: The Bone Metabolism Laboratory at the USDA Nutrition Center at Tufts University. Participants: 410 men and women age [greater than or equal to]65 years who participated in the 3-year Boston STOP IT trial to determine the effect of supplementation with 700 IU of vitamin [D.sub.3] plus calcium on incident falls (secondary endpoint). Intra-trial exposures of 25(OH)D and PTH were calculated as the mean of biannual measures up to and including the first fall. Main outcome measures: Incidence of first fall. Results: Intra-trial mean 25(OH)D was significantly associated with risk of falling in a U-shaped pattern; the range associated with minimal risk of falling was approximately 20 to 40 ng/mL. PTH was not significantly associated with risk of falling. Conclusions: The findings highlight the importance of maintaining the circulating 25(OH)D level between 20 and 40 ng/mL, the range that is also recommended for bone health. At PTH levels within the normal range, there was no detectible independent association of PTH with fall risk. Key Words: 25(OH)D, PTH, falls, vitamin D supplementation