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Vitamin D Status as a Determinant of Peak Bone Mass in Young Finnish Men

Division of Endocrinology, Department of Medicine (V.-V.V., M.J.V.), and Department of Clinical Chemistry (H.A., U.-H.S.), Helsinki University Central Hospital, FIN-00290 Helsinki, Finland; Finnish Defense Forces (E.Le., T.S.), FIN-00131 Helsinki, Finland; Department of Statistics, University of Turku (E.Lö.), FIN-20014 Turku, Finland; and Department of Health Sciences, University of Jyväskylä (H.S.), FIN-40014 Jyväskylä, Finland

Address all correspondence and requests for reprints to: Dr. Matti Välimäki, Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland. E-mail: matti.valimaki{at}hus.fi.

Severe vitamin D deficiency causes rickets, but scarce data are available about the extent to which vitamin D status determines the development of the peak bone mass in young adults. Our aim was to evaluate the prevalence of vitamin D deficiency [serum 25-hydroxyvitamin D (25-OHD) less than the lower limit of the reference range of 20–105 nmol/liter] and the relationship between vitamin D status and peak bone mass among young Finnish men. A cross-sectional study of determinants of peak bone mass with data on lifestyle factors collected retrospectively was performed in 220 young men, aged 18.3–20.6 yr. One hundred and seventy men were recruits of the Finnish Army, and 50 were men of similar age who had postponed their military service for reasons not related to health. Bone mineral content, bone mineral density, and scan area were measured in lumbar spine and upper femur by dual energy x-ray absorptiometry. Serum 25-OHD concentrations were followed prospectively for 1 yr. In July 2000, only 0.9% of the men had vitamin D deficiency, but 6 months later, in the winter, the respective percentage was 38.9%. After adjusting for age, height, weight, exercise, smoking, calcium, and alcohol intake, there existed a positive correlation between serum 25-OHD and bone mineral content at lumbar spine (P = 0.057), femoral neck (P = 0.041), trochanter (P = 0.010), and total hip (P = 0.025). The correlation coefficients for the bone mineral densities at the four measurement sites were 0.035, 0.061, 0.056, and 0.068, respectively. No correlation was found to scan area. We conclude that vitamin D deficiency is very common in Finnish young men in the winter, and it may have detrimental effects on the acquisition of maximal peak bone mass. As in Finland vitamin D supplementation to infants is now stopped at the age of 3 yr, it can be asked whether at our latitude it should be continued from that age onward, not for the prevention of rickets, but as prophylaxis for osteoporosis.

This work was supported by a grant from the Ministry of Education (Helsinki, Finland) and research funding from Helsinki University Central Hospital (Erityisvaltionosuus).

Abbreviations: BCE, Bone collagen equivalent; BMC, bone mineral content; BMD, bone mineral density; CV, coefficient of variation; iPTH, intact PTH; NTX, type I collagen amino-terminal telopeptide; 25-OHD, 25-hydroxyvitamin D; PINP, type I procollagen amino-terminal propeptide; TRAP5b, tartrate-resistant acid phosphatase 5b.

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