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  • Alexander Carswell
    University of East Anglia
  • Thomas J O'Leary
    Army Health and Performance Research
  • Paul Swinton
    Robert Gordon University
  • Sarah Jackson
    Army Health and Performance Research
  • Jonathan Tang
    University of East Anglia
  • Sam Oliver
  • Rachel M Izard
    Defence Science and Technology
  • Neil P. Walsh
    Liverpool John Moores University
  • William Fraser
    University of East Anglia
  • Julie P Greeves
    University of East Anglia
The relationship between vitamin D metabolites and lower body (pelvis and lower limb) overuse injury is unclear. In a prospective cohort study, we investigated the association between vitamin D metabolites and incidence of lower body overuse musculoskeletal and bone stress injury in young adults undergoing initial military training during all seasons. In 1637 men and 530 women (aged 22.6 ± 7.5 years; body mass index [BMI], 24.0 ± 2.6 kg/m-2; 94.3% white ethnicity), we measured serum 25-hydroxyvitamin D (25(OH)D) and 24,25-dihydroxyvitamin D (24,25(OH)2D) by high-performance liquid chromatography tandem mass spectrometry, and 1,25-dihydroxyvitamin D (1,25(OH)2D) by immunoassay during week 1 of training. We examined whether the relationship between 25(OH)D and 1,25(OH)2D:24,25(OH)2D ratio was associated with overuse injury. During 12 weeks of training, 21.0% sustained ≥1 overuse musculoskeletal injury, and 5.6% sustained ≥1 bone stress injury. After controlling for sex, BMI, 2.4 km run time, smoking, bone injury history, and Army training course (Officer, standard, or Infantry), lower body overuse musculoskeletal injury incidence was higher for participants within the second lowest versus highest quartile of 24,25(OH)2D (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.13–2.32; p = 0.009) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2D:24,25(OH)2D (OR = 6.30; 95% CI 1.89–21.2; p = 0.003). Lower body bone stress injury incidence was higher for participants within the lowest versus highest quartile of 24,25(OH)2D (OR = 4.02; 95% CI 1.82–8.87; p 

Keywords

  • Vitamin D, Injury, Nutrition, Exercise, Musculoskeletal
Original languageEnglish
Pages (from-to)1453-1464
JournalJournal of Bone and Mineral Research
Volume38
Issue number10
Early online date1 Aug 2023
DOIs
Publication statusPublished - 1 Oct 2023

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