Unraveling the relationship between serum 25-hydroxyvitamin D levels and trabecular bone score in American adults

Abstract

INTRODUCTION Trabecular bone score (TBS) is a novel way for clinicians to evaluate bone quality. It is directly associated with the mechanical strength of bones and helps predict fractures. Vitamin D, a secosteroid that enhances calcium absorption, is commonly used to strengthen the skeletal system. OBJECTIVES The present analysis aimed to determine the relationship between vitamin D levels and TBS by analyzing data from the National Health and Nutrition Examination Survey. PATIENTS AND METHODS A total of 4464 persons (2148 men and 2316 women) were included in our study. The participants were analyzed according to sex, obesity status, and T‑score using regression models. RESULTS We noted a remarkably positive relationship between serum levels of 25‑hydroxyvitamin D (25[OH]D) and TBS after the results were fully adjusted (β = 0.319; 95% CI, 0.145–0.494; P <0.001). T‑score analysis showed that serum 25(OH)D levels were related to TBS in the group of participants with normal bone mineral density (T‑score >–1) (β = 0.311; 95% CI, 0.097–0.525; P = 0.005). However, in the osteopenia (T‑score between –1 and –2.5) and osteoporosis (T‑score 0.05). CONCLUSIONS Our study shows that low serum levels of 25(OH)D may decrease the TBS, which rep‑ resents the skeletal microarchitecture and is a fracture risk factor in individuals with normal T‑scores.