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American Journal of Epidemiology Advance Access published online on August 22, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm210
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Association between Plasma 25-Hydroxyvitamin D Levels and Fracture Risk

The EPIC-Oxford Study

Andrew W. Roddam1, Rachel Neale2, Paul Appleby1, Naomi E. Allen1, Sarah Tipper1 and Timothy J. Key1

1 Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom
2 Queensland Institute of Medical Research, Brisbane, Australia

Correspondence to Dr. Andrew Roddam, Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, United Kingdom (e-mail: andrew.roddam{at}ceu.ox.ac.uk).

Received for publication April 18, 2007. Accepted for publication June 15, 2007.

The importance of vitamin D for bone health is well established, but few data exist on the relation between plasma levels of 25-hydroxyvitamin D and risk of fracture. The authors examined this association within the EPIC-Oxford (European Prospective Investigation into Cancer and Nutrition-Oxford cohort) study of men and women in the United Kingdom (1993–1999). Five years after recruitment, participants completed a follow-up questionnaire where fracture incidence was self-reported. Plasma 25-hydroxyvitamin D concentration was measured in 730 incident fracture cases and 1,445 matched controls. There was a clear association between plasma 25-hydroxyvitamin D concentration and month of blood draw, the highest values being during the summer months. Among women, there were significant relations between 25-hydroxyvitamin D levels and age, body mass index, marital status, use of hormone therapy, physical activity, diet group, dietary intake of vitamin D, and alcohol. Similar relations were seen among men, although often they were nonsignificant because of smaller numbers. There was no evidence of an association between plasma 25-hydroxyvitamin D and fracture risk for men or women; the relative risks associated with a doubling of plasma 25-hydroxyvitamin D were 1.15 (95% confidence interval: 0.82, 1.61) and 0.95 (95% confidence interval: 0.80, 1.13), respectively. These results were not affected by adjustment for potential confounders and were consistent across a number of subgroups.

calcifediol; cohort studies; fractures, bone; 25-hydroxyvitamin D 2; vitamin D

Abbreviations: CI, confidence interval; EPIC-Oxford, European Prospective Investigation into Cancer and Nutrition-Oxford cohort


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