Vitamin D status among postmenopausal osteoporotic women: a hospital based cross-sectional study from Northern Sri Lanka.

Abstract

Background Vitamin D deficiency is common among post-menopausal women and it is important to treat vitamin D deficiency to prevent falls and fractures in patients with osteoporosis. Few studies examined the prevalence of vitamin D deficiency in general population of Sri Lanka but no studies to date done among post-menopausal women with osteoporosis. This is the first study of such kind conducted to evaluate the serum vitamin D levels and factors related to Vitamin D deficiency among postmenopausal women.Methodology Hospital based Cross -sectional study was conducted at the Endocrine Unit, Teaching Hospital from January to December 2018.During the study period 105 postmenopausal women registered for DEXA scan with Endocrine Unit were recruited to the study. Data collection was done by investigators and blood sample was taken from each participant by registered nursing officers and sample was analysed by using immunohistochemistry assays. Serum Vitamin D levels were categorized and data analysis was done using SPSS 26.Results Mean age of 105 postmenopausal women was 67.7 with minimum 33 and maximum 84 years. Mean Vitamin D levels were 27.5(range11.7-52.5ng/ml). Vitamin D levels were adequate in only 36.2% (95%CI: 27.4-45.7) of women, 44% had insufficient levels and deficiency was present in 19% (95%CI: 12.4-27.4) of participants. Among the 105 women 20% were vegetarian and 53% of them consuming milk on average 3 days per week, 76.2% consuming fish on average 2 days per week, 64.8% consuming egg on average 1 day per week. Furthermore seventy five participants (71.4%) reported adequate level of sun exposure (>30minutes).Commonly reported vitamin deficiency symptoms includes paraesthesia (57.1%),bone pain (55.2%), easy fatigability (54.3%), malaise (51.4%), muscle cramps (43.8%) and proximal myopathy (40.0%).Among 71(66.7%) completed bone density assessment,38% (27.3-49.7) of them showed osteoporosis range. Vertebral Z score showed a significant correlation with vitamin D level(r-0.252, P-0.034).Conclusion Prevalence of vitamin D deficiency is relatively high among the post-menopausal women with a provisional diagnosis of osteoporosis. It is essential to correct vitamin D deficiency with supplementation when initiating treatment for osteoporosis. So vitamin D testing is desirable in decision making to treat or not to treat.

Impact of Vitamin D Elements and Osteoporosis Factors in Postmenopausal Iraqi Women with T2DM

“…Some research has suggested that vitamin D may have a direct (through its function in pancreatic beta-cell activation and sensitive organs) or indirect (by calcium homeostasis control) favorable influence on insulin secretion and sensitivity [30]. Osteoporosis is a well-known fact among postmenopausal women, and several risk factors have been linked to this high prevalence, including vitamin, D deficiency [31]. The National, Health and Nutrition, Examination, Survey III (NHANES III) found a link between 25(OH) D and BMD in 13,432 participants, including whites, Hispanics, and blacks [32].…”

Effects of preoperative serum vitamin D levels on early clinical function outcomes and the moderate-to-severe pain prevalence in postmenopausal women after primary total knee arthroplasty

“…13,14 The clinical manifestation of vitamin D deficiency also depends mostly on the degree and duration of the defect, including paresthesia, muscle cramps, bone pain, proximal myopathy, walking difficulty, decreased bone mineral density, and fractures. 15,16 Several studies have shown that vitamin D status is closely linked to the occurrence and development of osteoarthritis and potential adverse effects post-TKA. However, the impact of vitamin D deficiency on early postoperative outcomes in postmenopausal women scheduled for TKA remains unclear.…”

“…Postmenopausal status and low estrogen levels are associated with joint pain and symptoms, which predominantly occur between the ages of 50 to 59 years 13,14 . The clinical manifestation of vitamin D deficiency also depends mostly on the degree and duration of the defect, including paresthesia, muscle cramps, bone pain, proximal myopathy, walking difficulty, decreased bone mineral density, and fractures 15,16 …”