No Association between Vitamin D Deficiency and Markers of Bone Health in Athletes

Purpose Adequate vitamin D (25(OH)D) is required to maintain good bone health, yet many athletes are 25(OH)D deficient. This study sought to examine the relation between serum 25(OH)D and measures of bone health (bone mineral density (BMD) and T-score) in an ethnically diverse athletic population. Methods Nine hundred and fifty male athletes presented for precompetition medical assessment in our facility. An additional 436 individuals registered with a Qatari sporting federation (such as sailing, archery, shooting, bowling) but exercising <2 hwk(-1) were used as control population. There were 30 Asian, 242 Black African, 235 Caucasian, 491 from Gulf Cooperation Countries, 336 Middle Eastern, and 52 Persian participants. All individuals undertook bone densitometry and body composition analysis by dual-energy x-ray absorptiometry and serum 25(OH)D evaluation. Results From 950 athletes, 17.5% demonstrated severe deficiency, 39.2% demonstrated deficiency, 24.5% demonstrated insufficiency, and 18.8% demonstrated sufficiency, compared with 436 controls, 25.9% of whom demonstrated severe deficiency, 46.3% demonstrated deficiency, 19.0% demonstrated insufficiency, and 8.7% demonstrated sufficiency. No athlete presented with a T-score suggestive of osteoporosis (-2.5 SD) or osteopenia (-1.0 SD) at hip total. After adjustment for age, anthropometry, ethnicity, and athletic participation, there was no association between 25(OH)D and any BMD and T-score at any site within athletes. African and Caucasian athletes present with greater (P < 0.05) BMD and T-scores at the spine, neck, and hip total than those of Asian, Gulf Cooperation Countries, Middle Eastern, and Persian ethnicities. Athletes participating in high-impact sports present with higher measures (P < 0.05) of bone health than control participants regardless of 25(OH)D status. Conclusions There is no association between 25(OH)D and BMD and T-score for any site within male athletes after adjusting for age, ethnicity, and sporting participation.