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Endocrine Abstracts (2023) 94 OC1.1 | DOI: 10.1530/endoabs.94.OC1.1

SFEBES2023 Oral Communications Bone and Calcium (6 abstracts)

Vitamin D metabolites are associated with overuse musculoskeletal and bone stress injury in young adults

Alexander Carswell 1 , Thomas O’Leary 2 , Paul Swinton 3 , Sarah Jackson 2 , Jonathan Tang 1 , Samuel Oliver 4 , Rachel Izard 5 , Neil Walsh 6 , William Fraser 1 & Julie Greeves 2


1University of East Anglia, Norwich, United Kingdom. 2Army Health and Performance Research, Andover, United Kingdom. 3Robert Gordon University, Aberdeen, United Kingdom. 4Bangor University, Bangor, United Kingdom. 5Defence Science and Technology, Porton Down, United Kingdom. 6Liverpool John Moores University, Liverpool, United Kingdom


We investigated the association between vitamin D metabolites and incidence of lower body (pelvis and lower limb) overuse musculoskeletal and bone stress injury in 1637 men and 530 women (22.6 ± 7.5 years), undergoing 12 weeks initial military training. 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 training week 1. Using logistic regression, we examined whether vitamin D metabolites were associated with overuse injury, including whether the relationship between 25(OH)D and 1,25(OH)2D:24,25(OH)2D ratio was associated with overuse injury. During 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, overuse musculoskeletal injury incidence was higher for participants within the second lowest vs highest quartile of 24,25(OH)2D (OR:1.62 [95%CI 1.13-2.32; P=0.009]; 3.2-5.1 vs 7.7-29.6 nmol·L-1) and lowest vs 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]; 6.9-38.5 nmol·L-1 and 125-307 vs 107.2-222.5 nmol·L-1 and 6-32). Bone stress injury incidence was higher for participants within the lowest vs highest quartile of 24,25(OH)2D (OR:4.02 [95%CI 1.82-8.87; P<0.001]; 0.4-3.1 vs 7.7-29.6 nmol·L-1) and lowest vs highest cluster of 25(OH)D and 1,25(OH)2D:24,25(OH)2D (OR:22.08 [95%CI 3.26-149.4; P=0.001]), after controlling for the same covariates. Greater conversion of 25(OH)D to 24,25(OH)2D, relative to 1,25(OH)2D (i.e., low 1,25(OH)2D:24,25(OH)2D), and higher serum 24,25(OH)2D were associated with a lower incidence of overuse injury. Serum 24,25(OH)2D may have a role in preventing overuse injury during arduous physical training.

Volume 94

Society for Endocrinology BES 2023

Glasgow, UK
13 Nov 2023 - 15 Nov 2023

Society for Endocrinology 

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