Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Determining the Required Vitamin D Level for Bone Health Based on Bone Turnover Markers

  • Ismail, Tuan Salwani Tuan (Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Muda, Bayani Che (Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Rosdi, Roznie Aida Mohd (Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Zainuddin, Azalina (Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Isa, Salbiah (Advanced Medical and Dental Institute, Universiti Sains Malaysia) ;
  • Mustapaha, Zulkarnain (Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia)
  • Received : 2017.10.10
  • Accepted : 2017.12.01
  • Published : 2017.12.31
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Abstract

To date, no clear threshold that has been established for defining an adequate store of vitamin D for bone health. Therefore, this study aims to determine the required level of vitamin D to maintain a healthy skeleton based on bone remodelling process among healthy adult population. This was a cross sectional study, involving a healthy adult population in Kota Bharu, Malaysia, aged 18~50 years. We measured serum 25(OH)D (vitamin D), serum parathyroid hormone (PTH), serum C-terminal telopeptide of type 1 collagen (CTX), and Procollagen 1 Intact N-Terminal (P1NP) in 120 healthy adults selected via multi stage sampling (64 males, 56 females) from 6 subdistricts in Kota Bharu. The mean level of 25(OH)D was 23.50 (${\pm}8.74$) nmol/L. There was a significant difference of the vitamin D level between genders ($26.81{\pm}8.3nmol/L$ vs $19.72{\pm}7.68nmol/L$ in males and females respectively) (p value<0.001). More than 50% of female subjects had 25(OH)D less than 20 nmol/L, while only 20.3% of male subjects had 25(OH)D below 20 nmol/L. Based on the LOESS plot, the bone turnover markers showed a plateauing result, at the 25(OH)D level of 35 nmol/L for CTX and 20 nmol/L for P1NP. Contrastingly, PTH showed a step rise in the 25(OH)D level of 20 nmol/L. Based on the LOESS plot for CTX, P1NP and PTH versus 25(OH)D, level of vitamin D between 20 to 35 nmol/L is recommended to maintain healthy skeleton.

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References

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