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Volume 348:1927-1928 May 8, 2003 Number 19
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Serum Retinol Levels and Fracture Risk

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by Lips, P.
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by Michaëlsson, K.
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To the Editor: Michaëlsson et al. (Jan. 23 issue)1 show that the risk of fracture increases in Swedish men with increased intake (and serum levels) of vitamin A. Furthermore, Lips, in an accompanying editorial,2 points out that bone mineral density decreases at both the lower and upper extremes of "normal" human vitamin A intake.3 However, vitamin D deficiency also contributes to osteoporosis, and excessive vitamin A reduces the efficacy of vitamin D, preventing vitamin D intoxication and causing rickets in normally replete animals.4 This is because vitamin D acts through ligand-bound vitamin D receptor–retinol X receptor heterodimeric complexes, whereas excessive . . . [Full Text of this Article]



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