Journal Article

Association of standardized serum 25-hydroxyvitamin D with falls in post-menopausal women

Larsen, Jennifer, Borchardt, Gretta, Mosiman, Samuel, Stacey, Mark L., Binkley, Neil, Lappe, Joan M., Sempos, Christopher T.

2025

Overview

Summary Vitamin D status has long been related to falls risk. In this planned secondary analysis of a vitamin supplementation trial in postmenopausal women, standardized 25-hydroxyvitamin D concentration up to 60 ng/mL was not associated with increased falls. Women with 25(OH)D ≥ 60 ng/mL had higher odds of ≥ 2 falls. Purpose Falls are common and cause fractures. High circulating 25(OH)D may increase falls risk; thus, recent guidance recommends 25(OH)D not exceed 50 ng/mL. Prior falls studies have not reported standardized 25(OH)D (s25D) data. The purpose of this planned secondary analysis of a 4-year calcium/vitamin D supplementation trial was to evaluate the association of s25D with falls. Methods This study recruited 2,303 postmenopausal women. The analytic dataset consisted of pooled concatenated data from years 2–4 (N Total  = 5,732). Serum 25(OH)D was measured annually and subsequently retrospectively standardized using Vitamin D Standardization Program methods. Falls were recorded by diary. Incidence for ≥ 1 fall and ≥ 2 falls was assessed by s25D group (≤ 20, 20- < 30, 30- < 40, 40- < 50, 50- < 60 and ≥ 60 ng/mL) using multivariable logistic regression. Results Mean (SD) baseline s25D was 32.6 ng/mL (8.3) with no difference between supplement and placebo groups. s25D increased to 41.3 ng/mL at year 2 in the supplement group then remained stable. By s25D group, incidence for ≥ 1 fall varied from 22–32% (p = 0.19). For ≥ 2 falls incidence varied (p = 0.03) from 6% (< 20 ng/mL) to 17% (≥ 60 ng/mL.) There was no significant association between s25D and ≥ 1 fall. Those with s25D ≥ 60 ng/mL had a higher adjusted odds of ≥ 2 falls (OR = 1.99 ± 1.2–3.3) compared to women with s25D of 30- < 40 ng/mL. Conclusion s25D up to 60 ng/mL was not associated with greater risk for ≥ 1 or ≥ 2 falls. Women with a s25D ≥ 60 ng/mL were at higher odds for ≥ 2 falls, however this group included only ~ 2% of study observations; therefore, confirmation in other cohorts is necessary.

• Publisher: Springer London,Springer Nature B.V
• Subject: 25-Hydroxyvitamin D / Accidental Falls - statistics & numerical data / Aged / Bone Density Conservation Agents - administration & dosage / Bone Density Conservation Agents - therapeutic use / Dietary Supplements / Endocrinology / Falls / Female / Health risks / Humans / Medicine / Medicine & Public Health / Menopause / Middle Aged / Original Article / Orthopedics / Post-menopause / Postmenopause - blood / Retrospective Studies / Rheumatology / Risk Assessment - methods / Vitamin D / Vitamin D - administration & dosage / Vitamin D - analogs & derivatives / Vitamin D - blood / Vitamin D Deficiency - blood / Vitamin D Deficiency - complications / Vitamin D Deficiency - epidemiology / Womens health