In older men, lower 25-hydroxycholecalciferol (25OHD) and higher parathyroid hormone (PTH) concentrations are associated with faster age-related decline in bone microarchitecture, a new study finds. Kidney function per se did not alter these results.
The findings are from the STRAMBO (Structure of the Aging Men’s Bones) study of 826 men aged 60 years or older. Investigators used high resolution peripheral quantitative computed tomography to assess bone microarchitecture in the cortical vs trabecular bone at the distal radius and tibia at baseline, 4 years, and 8 years. They analyzed results by both vitamin D and PTH categories.
At both the distal radius and tibia, total bone mineral density, cortical thickness, cortical area, and cortical bone mineral density significantly decreased and trabecular area increased more rapidly due to conversion of tissue in men with 25OHD levels of 20 ng/mL or less (or less than 12 ng/mL) compared with more than 30 ng/mL (vitamin D sufficiency). Results were similar in analyses of the whole cohort and in analyses restricted to men with an estimated glomerular filtration rate (eGFR) greater than 60 mL/min/1.73 m2. The findings also did not differ in analyses of men who did not take calcium or vitamin supplements during the 8 years.
Bone microarchitecture declined faster when PTH values exceed 44 pg/mL, which is the upper limit of normal range, Pawel Szulc, MD, PhD, of INSERM UMR 1033, Hôpital Edouard Herriot in Lyon, France, and colleagues reported in the Journal of Bone and Mineral Research.
According to Dr Szulc’s team, the results suggest that “current vitamin D/PTH status is a strong determinant of bone microarchitectural decline in older home-dwelling men and seem to explain the morphological basis underlying the loss of bone mass and strength in older individuals with vitamin D deficiency and SHPT.”
The study was limited to older White men, so additional research is needed in other populations.
Disclosure: This research was supported by Roche pharmaceutical company, Basel, Switzerland, Agence Nationale de la Recherche, Abondement ANVAR, and Hospices Civils de Lyon. Please see the original reference for a full list of disclosures.
Bobillier A, Wagner P, Whittier DE, et al. Association of the vitamin D and parathyroid hormone status with the ageing-related decline of bone microarchitecture in older men – the prospective STRAMBO study. J Bone Miner Res. Published online July 26, 2022. doi:10.1002/jbmr.4657