TY - JOUR

T1 - Vitamin D metabolites are associated with musculoskeletal injury in young adults: a prospective cohort study

AU - Carswell, Alexander

AU - O'Leary, Thomas J

AU - Swinton, Paul

AU - Jackson, Sarah

AU - Tang, Jonathan

AU - Oliver, Sam

AU - Izard, Rachel M

AU - Walsh, Neil P.

AU - Fraser, William

AU - Greeves, Julie P

N1 - UK Ministry of Defence (Army)

PY - 2023/10/1

Y1 - 2023/10/1

N2 - 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 

AB - 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 

KW - Vitamin D

KW - Injury

KW - Nutrition

KW - Exercise

KW - Musculoskeletal

U2 - 10.1002/jbmr.4890

DO - 10.1002/jbmr.4890

M3 - Article

VL - 38

SP - 1453

EP - 1464

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 1523-4681

IS - 10

ER -