Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women

J Intern Med. 1999 May;245(5):509-16. doi: 10.1046/j.1365-2796.1999.00474.x.


Objectives: To determine the relationships between serum vitamin D metabolites, bone mass, and dietary calcium and phosphorus in a cohort of 510 healthy Danish perimenopausal women.

Design: A population-based cross-sectional study.

Subjects: A total of 510 healthy women aged 45-58 years, with amenorrhoea for 3-24 months. None of the women was using hormone replacement therapy.

Measurements: Measurements of total bone mineral content and regional bone mineral density were performed by dual-energy X-ray absorptiometry. Analyses of serum levels of 25-OHD and 1,25-(OH)2D, intact PTH, ionized calcium and phosphate, as well as biochemical markers of bone turnover in blood and urine. Assessment of calcium and phosphorus intake using dietary records.

Results: A consistent inverse relationship between serum 1,25-(OH)2D and bone mineral content/ density was found in whole-body mineral content (P = 0.001), spine (P = 0.005) and femoral neck (P<0.05). There was a positive relationship between levels of 1,25-(OH)2D and biochemical bone markers, indicating that high levels of 1,25-(OH)2D are accompanied by increased bone turnover. The dietary calcium:phosphorus ratio was inversely related to serum 1,25-(OH)2D (P = 0.04) and positively related to bone mineral density (P<0.0005). No relationships could be detected between levels of PTH, serum ionized calcium and phosphate, and serum vitamin D metabolites.

Conclusion: Within normal physiological range, elevated levels of 1,25-(OH)2D were associated with decreased bone mineral density and content, reduced calcium:phosphorus ratio in the diet and increased bone turnover.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Bone Density*
  • Calcium, Dietary / administration & dosage*
  • Calcium, Dietary / blood
  • Cross-Sectional Studies
  • Denmark
  • Diet Records
  • Female
  • Humans
  • Middle Aged
  • Parathyroid Hormone / blood
  • Phosphorus, Dietary / administration & dosage*
  • Phosphorus, Dietary / blood
  • Premenopause*
  • Reference Values
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood*


  • Calcium, Dietary
  • Parathyroid Hormone
  • Phosphorus, Dietary
  • Vitamin D
  • 1,25-dihydroxyvitamin D
  • 25-hydroxyvitamin D