Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial

Abstract

Bone turnover markers (BTMs) are used to evaluate bone health together with bone mineral density and fracture assessment. Vitamin D supplementation is widely used to prevent and treat musculoskeletal diseases but existing data on vitamin D effects on markers of bone resorption and formation are inconsistent. We therefore examined the effects of vitamin D supplementation on bone-specific alkaline phosphatase (bALP), osteocalcin (OC), C-terminal telopeptide (CTX), and procollagen type 1 N-terminal propeptide (P1NP). This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial, a single-center, double-blind, randomized, placebo-controlled trial (RCT) performed at the Medical University of Graz, Austria (2011–2014). Two hundred individuals with arterial hypertension and 25-hydroxyvitamin D (25[OH]D) levels <75 nmol/L were randomized to 2800 IU of vitamin D daily or placebo for eight weeks. One hundred ninety-seven participants (60.2 ± 11.1 years; 47% women) were included in this analysis. Vitamin D had no significant effect on bALP (mean treatment effect (MTE) 0.013, 95% CI −0.029 to 0.056 µg/L; p = 0.533), CTX (MTE 0.024, 95% CI −0.163 to 0.210 ng/mL, p = 0.802), OC (MTE 0.020, 95% CI −0.062 to 0.103 ng/mL, p = 0.626), or P1NP (MTE −0.021, 95% CI −0.099 to 0.057 ng/mL, p = 0.597). Analyzing patients with 25(OH)D levels <50 nmol/L separately (n = 74) left results largely unchanged. In hypertensive patients with low 25(OH)D levels, we observed no significant effect of vitamin D supplementation for eight weeks on BTMs.

A randomised controlled trial comparing the efficacy of micellised and fat-soluble vitamin D3 supplementation in healthy adults

“…Although most studies report no change in bone resorption/formation markers, some show decrease in either resorption marker alone or both following supplementation. Evaluation of bone markers in the present study may have provided additional information on bone turnover status (20)(21)(22)(23) .…”

Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial

“…The design and methods of this trial have been published [17,18]. The publication of this trial adheres to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement [19].…”

The relationships of alkaline phosphatase and bone alkaline phosphatase to the growth hormone/insulin-like growth factor-1 axis and vitamin D status in children with growth hormone deficiency

“…In children with growth hormone deficiency (GHD), ALP and BALP levels are decreased and rise significantly after the initiation of recombinant human growth hormone (rhGH) treatment (Juul et al, 1994;Ono et al, 1996;Tobiume et al, 1997;Eapen et al, 2008;Korpal-Szczyrska et al, 2008;Witkowska-Sędek et al, 2014). Vitamin D, which is necessary for normal calcium-phosphorus homeostasis and skeleton mineralization, also influences bone turnover during growth, but its role has not been fully explained (Barnes et al, 2006;Paradowska et al, 2007;Anderson et al, 2013;Koszowska et al, 2014;Thiering et al, 2015;Larijani et al, 2016;Ciresi et al, 2017;Schwetz et al, 2017). The effects of the GH/IGF-1 axis on bone turnover can be evaluated using the measurement of bone turnover markers (BTMs), including ALP and BALP (Ono et al, 1996;Locatelli et al, 2014;Devesa et al, 2016).…”

“…The effects of the GH/IGF-1 axis on bone turnover can be evaluated using the measurement of bone turnover markers (BTMs), including ALP and BALP (Ono et al, 1996;Locatelli et al, 2014;Devesa et al, 2016). The GH/IGF-1 axis can modulate vitamin D metabolism and, conversely, vitamin D can influence IGF-1 concentrations (Soliman et al, 2008;Bogazzi et al, 2011;Ameri et al, 2013;Ciresi et al, 2014;Witkowska-Sędek et al, 2016;Ciresi et al, 2017;Schwetz et al, 2017). Activation of vitamin D receptor (VDR) localised in osteoblasts, osteocytes, chondrocytes, and osteoclasts regulates cell proliferation, maturation, and mineralization as well as bone resorption.…”

“…Activation of vitamin D receptor (VDR) localised in osteoblasts, osteocytes, chondrocytes, and osteoclasts regulates cell proliferation, maturation, and mineralization as well as bone resorption. The effects of vitamin D on bone turnover are complex, but the results of studies evaluating associations between vitamin D and BTMs are divergent (Barnes et al, 2006;Anderson et al, 2013;Thiering et al, 2015;Larijani et al, 2016;Ciresi et al, 2017;Schwetz et al, 2017).…”