Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures : the Geelong Osteoporosis Study

Pasco, Julie A., Henry, Margaret J., Kotowicz, Mark A., Sanders, Kerrie M., Seeman, Ego, Pasco, John R., Schneider, Hans G. and Nicholson, Geoffrey C. 2004, Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures : the Geelong Osteoporosis Study, Journal of bone and mineral research, vol. 19, no. 5, pp. 752-758.

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Title Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures : the Geelong Osteoporosis Study
Author(s) Pasco, Julie A.
Henry, Margaret J.
Kotowicz, Mark A.
Sanders, Kerrie M.
Seeman, Ego
Pasco, John R.
Schneider, Hans G.
Nicholson, Geoffrey C.
Journal name Journal of bone and mineral research
Volume number 19
Issue number 5
Start page 752
End page 758
Total pages 7
Publisher Wiley - Blackwell
Place of publication Durham, NC
Publication date 2004-05
ISSN 0884-0431
Keyword(s) vitamin D
parathyroid hormone
bone turnover markers
seasonality;population studies
Summary In this population-based study, seasonal periodicity was seen with reduced serum vitamin D, increased serum PTH, and increased bone resorption in winter. This was associated with an increased proportion of falls resulting in fracture and an increased risk of wrist and hip fractures.

Introduction:
In a population of women who reside in a temperate climate and do not generally receive dietary vitamin D supplementation, we investigated whether seasonal vitamin D insufficiency is associated with increased risk of fracture.

Materials and Methods: An observational, cross-sectional, population-based study set in southeastern Australia (latitude 38–39° S). Participants were drawn from a well-defined community of 27,203 women ≥55 years old: 287 randomly selected from electoral rolls, 1635 with incident fractures, and 1358 presenting to a university hospital with falls. The main outcome measures were annual periodicities of ultraviolet radiation, serum 25-hydroxyvitamin D [25(OH)D], serum parathyroid hormone (PTH), serum C-telopeptide (CTx), BMD, falls, and fractures.

Results:
Cyclic variations in serum 25(OH)D lagged 1 month behind ultraviolet radiation, peaking in summer and dipping in winter (p < 0.001). Periodicity of serum PTH was the inverse of serum 25(OH)D, with a phase shift delay of 1 month (p = 0.004). Peak serum CTx lagged peak serum PTH by 1–2 months. In late winter, a greater proportion of falls resulted in fracture (p < 0.001). Seasonal periodicity in 439 hip and 307 wrist fractures also followed a simple harmonic model (p = 0.078 and 0.002, respectively), peaking 1.5–3 months after the trough in 25(OH)D.

Conclusions:
A fall in 25(OH)D in winter is accompanied by increases in (1) PTH levels, (2) bone resorption, (3) the proportion of falls resulting in fracture, and (4) the frequency of hip and wrist fracture. Whether vitamin D supplementation in winter can reduce the population burden of fractures requires further investigation.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, American Society for Bone and Mineral Research
Persistent URL http://hdl.handle.net/10536/DRO/DU:30042798

Document type: Journal Article
Collection: School of Medicine
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