High bone turnover in Muslim women with vitamin D deficiency

Abstract

CHRONIC VITAMIN D DEFICIENCY may lead to osteomalacia and/or osteoporosis, with an increased risk of fragility fractures. 1 In Australia, with its multicultural population, a resurgence of vitamin D deficiency has been noted recently. 2 While there are reports of abnormalities in vitamin D metabolism in Muslim women, 3,4 there are no published data on fracture rates, bone mass measurements or bone turnover rates in this cohort. We aimed to determine the effect of vitamin D deficiency on bone turnover in Muslim women. METHODS 1.Methods ParticipantsMuslim women aged 20-65 years were invited to participate in our study through a pamphlet questionnaire, which was distributed in shopping centres and mosques in south-western Sydney in November 1999 to April 2000. We used a simple format with "yes or no" answers to obtain details about their (i) dress (whether they were veiled during daily outdoor activities), (ii) sun exposure (defined as more or less than 60 minutes of daily, outdoor sunlight exposure per week), and (iii) menopausal status. They were also asked to donate venous blood and to collect an early-morning, two-hour urine sample for analysis. Recruitment was undertaken during the summer months.We excluded from the study women who refused phlebotomy, had chronic medical disorders or were receiving medications that could interfere with bone turnover. Informed consent was obtained from all participants. Our ABSTRACT Objective: To measure bone turnover in Muslim women with vitamin D deficiency. Design: A cross-sectional study of a random sample of Muslim women aged 20-65 years, evaluated over a 6-month period from November 1999 to April 2000. Setting and participants: 146 women living in an urban community in southwestern Sydney with adequate opportunities for sun exposure. Main outcome measures: Bone turnover as measured by urinary deoxypyridinoline (DPYD) excretion rates; and vitamin D status as determined by 25-hydroxyvitamin D (25OHD) levels, serum calcium levels and parathyroid hormone (PTH) concentrations. Results: We analysed data on 119 Muslim women (mean [SEM] age, 46.6 [1.1] years) who met the inclusion criteria. There were 81 (68.1%) women with serum 25OHD levels < 30 nmol/L (defined as "severe" vitamin D deficiency). Fifty-five (46.2%) women had evidence of high bone turnover (urinary DPYD excretion > 6.5 nmol/mmol creatinine). The women with "severe" vitamin D deficiency had significantly higher serum PTH levels (7.3 [0.3] v 5.4 [0.5] pmol/L; P = 0.001) and higher urinary DPYD excretion (7.2 [0.3] v 5.4 [0.2] nmol/mmol creatinine; P = 0.003) than women with serum 25OHD levels у 30 nmol/L. No significant differences were seen in their ages, menopausal status or serum calcium and phosphate measurements. The risk of developing high bone turnover was significantly greater in the women with "severe" vitamin D deficiency (relative risk = 5.52; 95% CI, 2-14.8; 2 = 12.95; P = 0.0003). Conclusion: High bone turnover occurs in Muslim women with vitamin D MJA 2002; 177: 139-141 deficiency.

High Prevalence of Vitamin D Insufficiency in China: Relationship with the Levels of Parathyroid Hormone and Markers of Bone Turnover

“…Garnero et al [35] have indicated that vitamin D is unlikely to play a major role in regulating the systemic levels of bone turnover markers. In the present study, as reported in several previous studies [36], [37], we found a significant inverse correlation between the serum levels of 25(OH)D and bone turnover markers, independent of age and BMI. These data suggest that vitamin D insufficiency may be related to accelerated bone turnover, and subsequently, osteoporosis.…”

Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications

“…Five articles provided descriptive information on African or refugee medical and physical health derived from on-arrival screening or related services [30-34]; three discussed Vitamin D deficiency in veiled and dark-skinned women and their babies [35-37]; five were concerned with the mental health of refugees [15,38-41]; one with iron depletion in Arabic-speaking toddlers [42]; one examined the hospital utilisation of refugees based on their source country [43]; one examined the differential access rights of Temporary Permit Visa holders, as compared with refugees [44]; one studied the primary care utilisation patterns of 341 asylum seekers in Melbourne [45]; one studied the effectiveness of outpatient malarial treatment with African refugees [46]; one looked at the barriers to healthcare access for newly arrived African refugees [47]; one studied shared antenatal care by women of non-English speaking backgrounds [16]; and one studied the positive relationship between intravenous drug use and Human Immunodeficiency Virus in Indochinese communities [48]. …”

Vitamin D and Parathyroid Hormone Status in Female Garment Workers: A Case-Control Study in Bangladesh

“…Low level of vitamin D has been reported in the adult population of Malaysia [16], China [17], Thailand [18], Korea [19], and India [20, 21]. A study in Australia reported the high prevalence of vitamin D deficiency among the Australian Muslim healthy women [22]. Vitamin D containing food like high intake of fish, fortification of food with vitamin D, or supplementation of vitamin D may be the causes of these differences.…”