POOR VITAMIN D STATUS IS ASSOCIATED WITH A DETRIMENTAL EFFECT ON

MUSCULOSKELETAL HEALTH: RESULTS OF THE D-FINES STUDYA.L.Darling1, P.A.Lee1, F.K.Hanjra1, A.Osborn1, S.Patel2, A.Duckworth3, P.Cardew3, R. Gray4, J.LBerry5 S.A.Lanham-New1

1University of Surrey, GU2 7XH, 2 St. Helier Hospital, SM5 1AA, 3 Guildford Nuffield Hospital, GU2 7RF, 4 Royal Surrey Hospital, GU2 7XX, 5 University of Manchester, M13 9WL

AIMS

INTRODUCTION

•The aim of this work was to examine differences in Lumbar Spine BMD and Grip Strength S in Asian and Caucasian pre and postmenopausal women according to their 25(OH)D status.

METHODS

•The D-FINES study examined 373 Surrey-dwelling Caucasian (C) and Asian (A) women in four seasons of the year for diet, sunlight exposure, 25-hydroxyvitamin D (25(OH)D) and grip strength (GS). In the autumn season, lumbar spine bone mineral density (LSBMD) was also measured.

•They were assessed in four seasons of the year for vitamin D (25OHD) status, vitamin D dietary intake and UVB exposure.

RESULTS

•For GS, controlling for lean arm mass, a statistically significant difference between the four ethnic/menopausal groups (F=24.851, p<0.001) was found but no significant within subjects effect of season (F= 0.503, p=0.681) .

•There was no significant interaction between season and ethnic/menopausal group (F=0.303, p=0.974).

•Significant positive partial correlations were found for all women (p<0.001) in all seasons between 25(OH)D and GS.

•For all C as one group, significant positive correlations were found between 25(OH)D and GS in summer (r=0.307), autumn (r=0.223), winter (r=0.222) and spring (r=0.242), with p<0.001 for all seasons.

•However, this was not found for the A groups combined, or for the four groups separately (p>0.05).

DISCUSSION

• Overall, LS BMD was significantly higher in individuals with 25(OH)D >75nmol/l compared to those with <39nmol/l.

•These findings suggest poor 25(OH)D may be detrimental to bone health, which could potentially translate into increased fracture risk long-term.

•Also, 25(OH)D was positively correlated with GS in all women in all seasons, indicating low 25(OH)D may decrease GS, most likely via poorer muscle function.

•These findings are a cause for public health concern and certainly warrants further investigation.

This work is funded by the Food Standards Agency (N05064)- The views expressed are the

authors’ own

Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England

References1. Hypponen E, Power C. (2007) Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and

lifestyle predictors. Am J Clin Nutr (85) 860-8.

2. Roy, D.K., Berry, J.L., Rye, S.P., Adams, J.E., Swarbrick,C.M., King, Y., Silman, A.J., and O’Neill, T.W. (2007) Vitamin D status and bone mass in UK South Asian women Bone (40) 200-204

3 Shaw N.J. and Pal, B.R. (2002) Vitamin D deficiency in UK Asian families: activating a new concern Archives of Disease in Childhood (86)147-149

•Vitamin D deficiency is a common problem in the UK (1) and is especially widespread in Asian women (2) and their families (3).

•There is a considerable lack of data examining poor vitamin D status on bone health and muscle function in different UK ethnic groups.

*= significantly lower (p<0.05) than 75nmol/l+ group

Figure 1: Lumbar Spine BMD by 25(OH)D- Autumn

• When women were grouped by 25(OH)D (<30 nmol/l, 30-39nmol/l; 40-74nmol/l; 75nmol/l+), ANCOVA adjusting for BMI showed a significant difference in LS BMD between the groups for summer (p=0.042), autumn (p=0.002) winter (p=0.028) and spring (p=0.019) 25(OH)D.

•The 25(OH)D <30nmol/l and 30-39nmol/l groups had significantly lower LS BMD than those with >75nmol/l.

Figure 2: