University of Tasmania
vitamin D paper_manuscript_revised for OI_final_14 July 2016.docx (132.35 kB)

Cut-points for associations between vitamin D status and multiple musculoskeletal outcomes in middle-aged women

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posted on 2023-05-18, 22:27 authored by Feitong WuFeitong Wu, Karen WillsKaren Wills, Laura LaslettLaura Laslett, Oldenburg, B, Seibel, MJ, Graeme JonesGraeme Jones, Tania WinzenbergTania Winzenberg

This was the first study examining optimal vitamin D status for musculoskeletal health in middle-aged women. A 25-hydroxyvitamin D level of at least 29 to 33 nmol/L appears required for optimal musculoskeletal health, but the current cut-off of 50 nmol/L may be warranted.

INTRODUCTION: This study aimed to determine whether cut-points exist for associations between serum 25-hydroxyvitamin D (25OHD) and musculoskeletal health outcomes in middle-aged women, below which greater 25OHD levels are associated with musculoskeletal health benefits and above which no such associations exist.

METHODS: This is a cross-sectional study of 344 women aged 36-57 years. Cut-points for associations of serum 25OHD with lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD), lower limb muscle strength (LMS), timed up and go test (TUG), functional reach test (FRT), lateral reach test (LRT), and step test (ST) were explored using locally weighted regression smoothing and nonlinear least-squares estimation, and associations above and below the identified cut-points were estimated using segmented regression.

RESULTS: The prevalence of low 25OHD was 28 % (<50 nmol/L). Significant cut-points (nmol/L) were identified for FN BMD 31 (95 % confidence interval (CI): 18, 43), LS BMD 31 (17, 45), TUG 30 (24, 36), ST 33 (24, 31), FRT 31 (18, 43), and LMS 29 (8, 49) but not LRT (42 (-8, 93). Below these cut-points, there were beneficial associations between higher 25OHD level and each outcome, while above the cut-points, there were no beneficial associations.

CONCLUSIONS: In middle-aged women, there are thresholds for associations between serum 25OHD concentrations and bone density and most balance measures, suggesting that 25OHD levels of at least 29 to 33 nmol/L are required for optimal musculoskeletal health in this population. The current cut-off of 50 nmol/L may be higher than needed for some outcomes but appears warranted overall.


Publication title

Osteoporosis International








Menzies Institute for Medical Research


Springer UK

Place of publication

United Kingdom

Rights statement

Copyright 2016 International Osteoporosis Foundation and National Osteoporosis Foundation Copyright International Osteoporosis Foundation and National Osteoporosis Foundation 2016 This is a post-peer-review, pre-copyedit version of an article published in Osteoporosis International. The final authenticated version is available online at:

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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