High serum retinyl esters are not associated with reduced bone mineral density in the Third National Health and Nutrition Examination Survey, 1988-1994

Hypervitaminosis A is sometimes associated with abnormalities of calcium me tabolism and bone mineral status. A recent study found a negative associati on between reported dietary vitamin A intake and bone mineral density (BMD) . Some segments of the U.S. population have high fasting serum retinyl este r concentrations, a physiological marker that may reflect high and possibly excessive vitamin A intake. We examined the association between fasting se rum retinyl esters and BMD in the Third National Health and Nutrition Exami nation Survey, 1988-1994 (NHANES III), a large, nationally representative s ample of the U.S. population. BMD was measured for the femoral neck, trocha nter, intertrochanter, and total hip on all nonpregnant participants aged g reater than or equal to 20 years; 5790 participants also had complete data on fasting serum retinyl esters and covariates including age, body mass ind ex (BMI), smoking, alcohol consumption, dietary supplement use, diabetes, p hysical activity, and, among women, parity, menopausal status, and the use of oral contraceptives or estrogen-replacement therapy. The sample included non-Hispanic white, non-Hispanic black, and Mexican American men and women . We examined the association between fasting serum retinyl esters and BMD at each site, controlling for covariates with multiple linear regression. W e examined the association with osteopenia and osteoporosis with multiple l ogistic regression. Although the prevalences of high fasting serum retinyl esters concentration and low BMD were both substantial in this sample, ther e were no significant associations between fasting serum retinyl esters and any measure of bone mineral status.