Intra-trial Mean 25D and PTH Levels and Risk of Falling in Older Men and Women in the Boston STOP IT Trial

Context: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. Objective: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2022-05, Vol.107 (5), p.1932
Main Authors: Dawson-Hughes, Bess, Wang, Jifan, Barger, Kathryn, Bischoff-Ferrari, Heike A, Sempos, Christopher T, Durazo-Arvizu, Ramon A, Ceglia, Lisa
Format: Article
Language:English
Subjects:
Alfacalcidol
Calcifediol
Falls (Accidents)
Physiological aspects
Vitamin D
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Summary:Context: Supplementation with vitamin D has the potential to both reduce and increase risk of falling, and parathyroid hormone (PTH) may contribute to fall risk. Objective: To assess the associations of intra-trial mean circulating levels of 25-hydroxyvitamin D [25(OH)D] and PTH on incident falls in healthy older adults. Design: Observational within a clinical trial. Setting: The Bone Metabolism Laboratory at the USDA Nutrition Center at Tufts University. Participants: 410 men and women age [greater than or equal to]65 years who participated in the 3-year Boston STOP IT trial to determine the effect of supplementation with 700 IU of vitamin [D.sub.3] plus calcium on incident falls (secondary endpoint). Intra-trial exposures of 25(OH)D and PTH were calculated as the mean of biannual measures up to and including the first fall. Main outcome measures: Incidence of first fall. Results: Intra-trial mean 25(OH)D was significantly associated with risk of falling in a U-shaped pattern; the range associated with minimal risk of falling was approximately 20 to 40 ng/mL. PTH was not significantly associated with risk of falling. Conclusions: The findings highlight the importance of maintaining the circulating 25(OH)D level between 20 and 40 ng/mL, the range that is also recommended for bone health. At PTH levels within the normal range, there was no detectible independent association of PTH with fall risk. Key Words: 25(OH)D, PTH, falls, vitamin D supplementation
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgac012