Suboptimal vitamin D status among the South Asian UK population is widely reported; however, its impact on bone health is unclear. The aim of the present study was to conduct a comparative investigation of vitamin D status in postmenopausal South Asian (SA) and Caucasian (C) women and its relationship to parathyroid hormone (PTH) concentration, biochemical markers of bone turnover and bone quality. A cross-sectional study of community-dwelling women aged 50 -66 years was carried out. A total of sixty-six SA women of Pakistani origin and forty-two C women living in the same community were recruited. Fasting blood was taken for the measurement of vitamin D, PTH and biochemical markers of bone turnover, including type-1 collagen b C-telopeptide (bCTX), procollagen type-1 amino-terminal propeptide (P1NP), and bone-specific alkaline phosphatase (BAP) activity. Bone quality was assessed using broadband ultrasound attenuation (BUA). Total serum 25-hydroxyvitamin D (25(OH)D) was significantly lower in the SA women than the C women (medians: SA 10·5 v. C 47·1 nmol/l; P,0·001) This was associated with a significantly elevated serum PTH concentration in the SA group (medians: SA 7·3 v. C 4·5 pmol/l; P, 0·01). BAP activity was also significantly higher in the SA group, indicating elevated osteoblast activity and bone turnover (medians: SA 23·0 v. C 20·0 U/l; P,0·05). No significant differences were observed between the two groups for P1NP, bCTX or BUA. Although the SA women had significantly higher serum PTH and lower 25(OH)D concentrations than C women, this was not associated with significantly higher markers of bone resorption, or reduced bone quality in the SA women. Vitamin D: Bone turnover: South Asian womenSuboptimal vitamin D status among the South Asian UK population has been recognised for over 40 years, and is widely reported (1 -4) . Vitamin D deficiency impairs Ca and P absorption, resulting in poor mineralisation of the skeleton (5) , and is frequently associated with secondary hyperparathyroidism (1,6) ; therefore the impact of vitamin D deficiency on bone health is of concern, particularly among the elderly (3) . There is a lack of data regarding bone health and fracture risk in European minority ethnic populations, particularly those from the Indian subcontinent. As part of the recent Oslo Health Study, vitamin D status and biochemical markers of bone turnover were measured in Pakistanis aged 40 -60 years living in Oslo and compared with those of the local age-matched Norwegian population. Data from this study revealed that despite a high prevalence of vitamin D deficiency and secondary hyperparathyroidism in the Pakistani group, there was no difference in bone mineral density (BMD) measured at the forearm and there were only minor differences in bone turnover markers compared with the local Norwegian population (7) . The authors speculated that altered vitamin D metabolism in the Pakistani population protected their skeleton from bone loss. In contrast, studies of vitamin D status and bone mass in young...

IntroductionMycotic aneurysms account for a small proportion of all aneurysms. Escherichia coli a gram-negative organism, is recognised as a rare cause of aortic aneurysm. We report two cases of mycotic aneurysm caused by the same strain of multi-resistant Escherichia coli. The purpose of this case report is to highlight the possibility that this strain may be associated with an increased risk of endovascular infection especially in extra-aortic sites. These aneurysms can be difficult to detect and can have serious consequences.Case presentationIn case one, the patient presented with symptoms and signs of septicaemia secondary to a urinary tract infection. Despite adequate treatment the patient continued with pyrexia and raised inflammatory markers, therefore a series of CT scans of the abdomen and thorax were performed, which revealed two intra-thoracic pseudo-aneurysms with associated haematomas. In case two, the patient also developed Escherichia coli septicaemia. On day 44 he developed a swelling on the right side of his neck. An ultrasound scan showed a pseudoaneurysm of the right common carotid artery.ConclusionsWhilst a case report cannot prove that a heightened risk exists, we suggest that it is an area worthy of further surveillance. We recommend when older patients with atheromatosis develop prolonged Escherichia coli septicaemia, the possibility of an infected aneurysm should be borne in mind.

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