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Calcium, Vitamin D, and Parathyroid Hormone Status in Young White and Black Women: Association with Racial Differences in Bone Mass^*

DIANE E. MEIER, MARJORIE M. LUCKEY, SYLVAN WALLENSTEIN, THOMAS L. CLEMENS, ERIC S. ORWOLL and CAROL I. WASLIEN

Departments of Geriatrics and Adult Development, Obstetrics, Gynecology, and Reproductive Science, and Biomathematical Sciences, Mount Sinai Medical Center New York, New York 10029
Helen Hayes Hospital Haverstraw, New York 10993
Medical Research, Portland Veterans Administration Medical Center Portland, Oregon 97201
the School of Health Sciences, Hunter College CUNY, New York, New York 10021

Address all correspondence and requests for reprints to: Diane E. Meier, M.D., Department of Geriatrics and Adult Development, Box 1070, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York 10029.

The etiology of the racial disparity in bone mass and fracture rate is unknown. Since the PTH-vitamin D endocrine system is a major regulator of calcium metabolism and bone turnover, this cross-sectional study examined the relationship of radial and lumbar bone density to vitamin D metabolite and PTH concentrations and to calcium intake and excretion in 67 white and 70 black highly comparable, healthy, premenopausal women. Bone density at both radial and lumbar sites was higher in blacks than in whites. Serum 25-hydroxyvitamin D was slightly but not statistically significantly (P = 0.08), lower in blacks than in whites, but there were no racial differences in 1,25-dihydroxyvitamin D, PTH, or renal tubular maximum for reabsorption of phosphate. The mean 25-hydroxyvitamin D concentration in blacks was well within the normal range and was not associated with evidence of secondary hyperparathyroidism. There were no correlations of bone density to vitamin D or PTH concentrations. Although there were no racial differences in dietary intake of calcium and vitamin D or in sodium excretion, 24-h urinary calcium excretion was significantly lower in blacks than in whites, and calcium excretion was inversely associated with radial bone density. In contrast to previous reports, in healthy, normal weight, premenopausal black women there is no evidence of vitamin D deficiency or secondary hyperparathyroidism, suggesting that factors other than the vitamin D-PTH axis are responsible for racial differences in bone mass.

^* This work was supported by grants from The Commonwealth Fund, the NIA (IROI-AG-07113), NIAMS SCOR grant in osteoporosis (AR-39191), and Grant RR-71 for the General Clinical Research Center’s branch of the Division of Research Resources, NIH.

Recipient of a NIA Academic Award (IK08-AG-00358).

Received May 17, 1990.

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