Low Vitamin D Levels in Outpatient Postmenopausal Women from a Rheumatology Clinic in Madrid, Spain: Their Relationship with Bone Mineral Density

Abstract

To evaluate a possible relationship between vitamin D levels and bone mineral density (BMD) and the prevalence of hypovitaminosis in a population of postmenopausal women from a rheumatologic outpatient clinic in Madrid, Spain, 171 postmenopausal women (aged 47-66 years) divided into two groups (osteoporotic and nonosteoporotic, according to WHO criteria) were studied between November and June. Liver and kidney function were normal in all subjects. Serum parathyroid hormone (PTH) and calcidiol levels were determined and bone densitometry carried out at the lumbar spine and hip level. PTH and calcidiol serum levels did not show any correlation. Serum PTH was inversely related to BMD at both hip and lumbar spine in the total group, and at the hip with calcidiol levels lower than 37 nmol/l. Calcidiol was directly related to hip BMD only when levels were lower than 37 nmol/l. Results of a stepwise multiple regression analysis showed that the single factor which affected BMD at the hip was calcidiol in the subgroup with serum calcidiol levels below 37 nmol/l, while in the subgroup with serum calcidiol levels above 37 nmol/l, the main factor affecting hip BMD was serum PTH. The prevalence of vitamin D deficiency at a cutoff of 37 nmol/l was 64%. In summary, calcidiol serum levels below 37 nmol/l seem to affect bone mass, regardless of the effect of PTH. Vitamin D deficiency is a frequent finding in the postmenopausal women who attend a rheumatology outpatient clinic in Madrid. Vitamin D supplementation should therefore be considered in this population during the winter season.

Deficiencia de vitamina D en España: ¿realidad o mito?

“…This state of calciferol insufficiency is replicated in Spain, with results which we show in table 1 [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] . The interlaboratory variation in the different methodologies used makes a rigorous comparison difficult, but the table illustrates clearly that, in spite of a theoretical climatological ease of vitamin D synthesis in Spain, the levels are similar to, or even lower than those reported for central Europe or Scandinavia, as has been described in earlier works 39 .…”

Vitamin D insufficiency in older female community-dwelling acute hospital admissions and the response to supplementation

“…Previous studies have suggested that this may be a common occurrence (Bettica et al, 1999;Aguado et al, 2000). The explanation for the impaired PTH response is not readily apparent.…”

“…25-Hydroxyvitamin D insufficiency has been commonly described in the institutionalized older population of the northern hemisphere, but it has recently been proposed that insufficiency may indeed be more common in the general population than previously thought (Chapuy et al, 1996(Chapuy et al, , 1997bJacques et al, 1997;Bettica et al, 1999;Aguado et al, 2000;Inderjeeth et al, 2000;Oliveri et al, 2004). Combination calcium and vitamin D are commonly given for the treatment of osteoporosis.…”

Vitamin D deficiency does not increase the risk of rheumatoid arthritis: Comment on the article by Merlino et al

“…The fact that osteoporosis patients are usually prescribed oral and lower doses of NGB could explain why these patients are less concerned about jaw osteonecrosis. NGBs inhibit osteoclast activity but also have antiangiogenic effects, and, once incorporated into the bone, they are barely eliminated (7).…”