{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:26:06Z","timestamp":1792513566725,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging"],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Vitamin D deficiency is common in chronic kidney disease (CKD) and is associated with lower bone mineral density (BMD), decreased muscle strength, and increased hip fracture risk. Guidelines have suggested targeting 25-OH vitamin D (25(OH)D) levels between 20 and 30\u00a0ng\/ml. However, vitamin D metabolism is altered in CKD, and threshold levels for optimal BMD are unknown.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We included 1097 patients with hip fractures. CKD was defined as estimated glomerular filtration rate &amp;lt;60\u00a0ml\/min\/1.73\u00a0m (Mucsi et al., Clin. Nephrol., 2005, 64(4), 288\u2013294) and low BMD defined as T score \u2264 \u22122.5 at femoral neck. We assessed the association of 25(OH)D with low BMD in patients with and without CKD: using the conventional threshold 25(OH)D &amp;lt; 30\u00a0ng\/dl, as well as a new threshold.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> CKD was present in 479 (44%) patients. Using a threshold of 25(OH)D &amp;lt; 30\u00a0ng\/ml, there were no significant differences in patients with CKD and low BMD when compared to the other groups. We identified 27\u00a0ng\/ml as a better threshold with the Youden index. Using 25(OH)D &amp;lt; 27\u00a0ng\/ml as a threshold, 360 of 482 patients (74.7%) with low 25(OH)D had low BMD, compared to only 185\/276 (67%) of patients with adequate vitamin D, <jats:italic>p =<\/jats:italic> 0.02, which was irrespective of the presence or absence of CKD. Furthermore, patients with CKD and 25(OH)D &amp;lt; 27\u00a0ng\/ml had a higher odds ratio of mortality upon follow-up, 1.61, 95% CI: 1.08\u20132.39, compared to those with CKD and 25(OH)D \u2265 27\u00a0ng\/ml.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> We find that 25(OH)D &amp;lt; 27\u00a0ng\/ml is associated with low BMD in patients with and without CKD. Further prospective studies targeting vitamin D repletion to at least 27\u00a0ng\/ml and the outcome of hip fractures will be useful to validate these findings.<\/jats:p>","DOI":"10.3389\/fragi.2022.1026663","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T06:31:08Z","timestamp":1666333868000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["25-OH vitamin D threshold for optimal bone mineral density in elderly patients with chronic kidney disease"],"prefix":"10.3389","volume":"3","author":[{"given":"Debajyoti","family":"Roy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee Yong","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng Xi","family":"Kog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxiang","family":"Yeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Boon","family":"Poh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreekanth","family":"Koduri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Yin","family":"Chionh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehena","family":"Sultana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Hai Kiat Puar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1053\/j.jrn.2015.08.007","article-title":"The \u201cdose\u2013effect\u201d relationship between 25\u2013hydroxyvitamin D and muscle strength in hemodialysis patients favors a normal threshold of 30 ng\/mL for plasma 25\u2013hydroxyvitamin D","volume":"26","author":"Bataille","year":"2016","journal-title":"J. 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