Associations between vitamin e status and bone mineral density in children and adolescents aged 8 19 years: Evidence based on NHANES 2005 2006, 2017 2018

Abstract

Bone mineral density (BMD) in adolescence is a crucial determinant in osteoporosis and fragility fractures in older age. Vitamin E is the most abundant lipid-soluble antioxidant present in the blood. However, the association of vitamin E status with BMD in children and adolescents remains unclear. Methods We first measured the association of vitamin E status (serum ?-and ? tocopherol) with BMD in children and adolescents with the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were performed to evaluate their relationship after adjusting for a large range of covariates. Stratified analyses and interaction tests were used to explore their effects on different genders, ages, and races/ethnicities. Results 13,606 children and adolescents from NHANES (2005 2006, 2017 2018) were included in our analysis. Compared with the lowest ?-Tocopherol quartile, individuals in the highest ?-tocopherol quartile are likelier to be Non-Hispanic White and have a higher value of poverty income ratio (PIR). They have a lower value of serum phosphorus and lumbar spine BMD. Every 1umol/L increase in serum ?-and ?-tocopherol, the lumbar spine BMD decreased by-0.0016 and-0.0068 g/cm2. Compared with the lowest quartile serum ?-and ?-tocopherol concentration, individuals in the highest quartile have a-0.0223 and-0.0329 g/cm2 lower mean BMD, respectively. Interaction effects suggest that the negative effect is more prominent among female youth, individuals aged 8 13 years, non-Hispanic whites, Mexican Americans, and non-Hispanic blacks. Conclusions Our study indicates serum ?-and ?-Tocopherol are negatively correlated with lumbar BMD. Age, gender, and race may have a modifying effect on this relationship. Our study has an important clinical implication. A higher vitamin E status for children and adolescents could not improve BMD, even decrease BMD. More prospective research with stronger evidence is needed to verify our findings and their underlying mechanisms.