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Low serum 25-hydroxyvitamin D status in the pathogenesis of stress fractures in military personnel: An evidenced link to support injury risk management.
Armstrong, Richard A; Davey, Trish; Allsopp, Adrian J; Lanham-New, Susan A; Oduoza, Uche; Cooper, Jacqueline A; Montgomery, Hugh E; Fallowfield, Joanne L.
Afiliação
  • Armstrong RA; University College London Centre for Human Health and Performance and Institute for Sport, Exercise and Health, London, United Kingdom.
  • Davey T; Institute of Naval Medicine, Alverstoke, Hampshire, United Kingdom.
  • Allsopp AJ; Institute of Naval Medicine, Alverstoke, Hampshire, United Kingdom.
  • Lanham-New SA; Nutritional Sciences Department, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom.
  • Oduoza U; University College London Centre for Human Health and Performance and Institute for Sport, Exercise and Health, London, United Kingdom.
  • Cooper JA; University College London Centre for Human Health and Performance and Institute for Sport, Exercise and Health, London, United Kingdom.
  • Montgomery HE; University College London Centre for Human Health and Performance and Institute for Sport, Exercise and Health, London, United Kingdom.
  • Fallowfield JL; Institute of Naval Medicine, Alverstoke, Hampshire, United Kingdom.
PLoS One ; 15(3): e0229638, 2020.
Article em En | MEDLINE | ID: mdl-32208427
Stress fractures are common amongst healthy military recruits and athletes. Reduced vitamin D availability, measured by serum 25-hydroxyvitamin D (25OHD) status, has been associated with stress fracture risk during the 32-week Royal Marines (RM) training programme. A gene-environment interaction study was undertaken to explore this relationship to inform specific injury risk mitigation strategies. Fifty-one males who developed a stress fracture during RM training (n = 9 in weeks 1-15; n = 42 in weeks 16-32) and 141 uninjured controls were genotyped for the vitamin D receptor (VDR) FokI polymorphism. Serum 25OHD was measured at the start, middle and end (weeks 1, 15 and 32) of training. Serum 25OHD concentration increased in controls between weeks 1-15 (61.8±29.1 to 72.6±28.8 nmol/L, p = 0.01). Recruits who fractured did not show this rise and had lower week-15 25OHD concentration (p = 0.01). Higher week-15 25OHD concentration was associated with reduced stress fracture risk (adjusted OR 0.55[0.32-0.96] per 1SD increase, p = 0.04): the greater the increase in 25OHD, the greater the protective effect (p = 0.01). The f-allele was over-represented in fracture cases compared with controls (p<0.05). Baseline 25OHD status interacted with VDR genotype: a higher level was associated with reduced fracture risk in f-allele carriers (adjusted OR 0.39[0.17-0.91], p = 0.01). Improved 25OHD status between weeks 1-15 had a greater protective effect in FF genotype individuals (adjusted OR 0.31[0.12-0.81] vs. 1.78[0.90-3.49], p<0.01). Stress fracture risk in RM recruits is impacted by the interaction of VDR genotype with vitamin D status. This further supports the role of low serum vitamin D concentrations in causing stress fractures, and hence prophylactic vitamin D supplementation as an injury risk mitigation strategy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vitamina D / Deficiência de Vitamina D / Fraturas de Estresse / Militares Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Humans / Male País/Região como assunto: Europa Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vitamina D / Deficiência de Vitamina D / Fraturas de Estresse / Militares Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Humans / Male País/Região como assunto: Europa Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: Estados Unidos