An Association between Bioavailable 25-Hydroxyvitamin D and Bone Mineral Density in a Diverse Cohort of Collegiate Athletes

INTRODUCTION Although vitamin D is intimately involved in bone metabolism, the relationship between vitamin D status, as measured by serum total 25-hydroxyvitamin D [25(OH)D] concentration, and bone mineral density (BMD) is weak, particularly in non-White populations. Measurement of bioavailable 25(OH)D has been suggested as a better indicator of vitamin D status than total 25(OH)D concentration. To date, the bioavailable 25(OH)D biomarker has been explored minimally in athletic populations. The purpose of this study was to investigate the relationship between total and bioavailable 25(OH)D concentrations and BMD in collegiate athletes. METHODS NCAA Division 1 basketball and swimming athletes served as study participants (n = 53; 28 females, 25 males; 28 basketball players, 25 swimmers). All participants completed dual energy x-ray absorptiometry (DXA) scans for analysis of BMD, blood draws for vitamin D measures, and diet/lifestyle questionnaires. RESULTS Overall, total 25(OH)D was 80.0 + 13.9 nmol/L and bioavailable 25(OH)D was 6.0 ± 1.9 nmol/L. There was strong disagreement between total 25(OH)D and bioavailable 25(OH)D concentrations (κ = -0.299; r = -0.129) (p = 0.100); 53% of total participants and 77% of Black participants were classified differently (low vs. normal vitamin D status) based on total and bioavailable 25(OH)D criteria. Black participants had significantly lower total 25(OH)D and higher bioavailable 25(OH)D concentrations than White participants (59.5 vs. 102.5 nmol/L and 7.9 vs. 5.4 nmol/L, respectively) (p < 0.001). Total 25(OH)D and total BMD were not correlated, but bioavailable 25(OH)D and total BMD demonstrated a positive correlation (r = 0.618, p < 0.01). CONCLUSIONS These results suggest that bioavailable 25(OH)D concentration may be a better clinical measure of vitamin D status than total 25(OH)D in collegiate athletes as related to BMD, particularly in Black athletes. Further research on the utility of the bioavailable 25(OH)D biomarker in athletes is needed.