Unraveling the relationship between serum 25-hydroxyvitamin D levels and trabecular bone score in American adults

INTRODUCTION Trabecular bone score (TBS) is a novel way for clinicians to evaluate bone quality. It is directly associated with the mechanical strength of bones and helps predict fractures. Vitamin D, a secosteroid that enhances calcium absorption, is commonly used to strengthen the skeletal system. OBJECTIVES The present analysis aimed to determine the relationship between vitamin D levels and TBS by analyzing data from the National Health and Nutrition Examination Survey. PATIENTS AND METHODS A total of 4464 persons (2148 men and 2316 women) were included in our study. The participants were analyzed according to sex, obesity status, and T-score using regression models. RESULTS We noted a remarkably positive relationship between serum levels of 25-hydroxyvitamin D (25[OH]D) and TBS after the results were fully adjusted (beta = 0.319; 95% CI, 0.145-0.494; P <0.001). T-score analysis showed that serum 25(OH)D levels were related to TBS in the group of participants with normal bone mineral density (T-score >-1) (beta = 0.311; 95% CI, 0.097-0.525; P = 0.005). However, in the osteopenia (T-score between -1 and -2.5) and osteoporosis (T-score <-2.5) group there was no such association (P >0.05). CONCLUSIONS Our study shows that low serum levels of 25(OH)D may decrease the TBS, which represents the skeletal microarchitecture and is a fracture risk factor in individuals with normal T-scores.