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Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women

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Abstract

Hypovitaminosis D can result in low bone mass. The prevalence of hypovitaminosis D has public health implications, especially where data are lacking. Since diet and sunlight are the two souces of vitamin D, the results obtained in one geographical region may not be universally applicable. The aim of this study is to characterize the prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. We determined serum levels of 25-hydroxyvitamin D (25-OH-D), PTH, osteocalcin (OC), degradation products of C-terminal telopeptides of type-I collagen (CTx), dietary calcium intake and BMD at L2–L4 lumbar spine (LS) and femur neck (FN) in 319 randomly selected ambulatory postmenopausal women. The prevalence of hypovitaminosis D (serum 25-OH-D≤50 nmol/l) was 56.7%. On comparing patients with normal and low 25-OH-D, a significant difference was found in age (61.6±8.5 years versus 67.3±9.9 years; P<0.001), PTH (3.9±1.9 pmol/l versus 4.3±2.7 pmol/l; P<0.05), FN BMD (0.802±0.123 g/cm2 versus 0.744±0.125 g/cm2; P<0.001) and dietary calcium intake (714.4±199.4 g/day versus 607.9±233 g/day; P<0.001). Osteoporotic patients had a significantly lower 25-OH-D (37.6±19.8 nmol/l versus 56.4±24 nmol/l; P<0.001) and dietary calcium intake (519.2±244.5 mg/day versus 718.2±164.3 mg/day; P<0.001). After controlling for all other variables, 25-OH-D was found to be significantly associated with age, the average hours of sunshine in the 3 months prior to 25-OH-D level determination and dietary calcium intake (r 2=0.190; P<0.001). For FN BMD, significant independent predictors were age, body mass index, 25-OH-D and dietary calcium intake (r 2=0.435; P<0.001). The prevalence of hypovitaminosis D during spring, summer, autumn and winter was 71%, 46.3%, 49.4% and 56.7%, respectively. There was significant seasonal variation in 25-OH-D, PTH, OC, calcium intake and FN BMD. There is a high prevalence of hypovitaminosis D in healthy postmenopausal Hungarian women, and FN BMD is associated with serum 25-OH-D and dietary calcium intake.

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References

  1. Omdahl JL, Garry PJ, Hunsaker LA, Hunt WC, Goodwin JS (1982) Nutritional status in a healthy elderly population: vitamin D. Am J Clin Nutr 36:1225–1233

    CAS  PubMed  Google Scholar 

  2. Khaw KT, Sneyd MJ, Compston J (1992) Bone density parathyroid hormone and 25-hydroxyvitamin D concentrations in middle aged women. BMJ 305:273–277

    CAS  PubMed  Google Scholar 

  3. Ooms ME, Lips P, Roos JC et al (1995) Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res 10:1177–1784

    CAS  PubMed  Google Scholar 

  4. McAuley KA, Jones S, Lewis-Barned NJ, Manning P, Goulding A (1997) Low vitamin D status is common among elderly Dunedin women. N Z Med J 110:275–277

    CAS  PubMed  Google Scholar 

  5. Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G (1991) Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Int Med 115:505–512

    CAS  PubMed  Google Scholar 

  6. Hollis BW (1996) Assessment of vitamin D nutritional and hormonal status: what to measure and how to do it. Calcif Tissue Int 58:4–5

    Article  CAS  PubMed  Google Scholar 

  7. Tsai KS, Hsu SH, Cheng JP, Yang RS (1997) Vitamin D stores of urban women in Taipei: effect on bone density and bone turnover, and seasonal variation. Bone 20:371–374

    Article  CAS  PubMed  Google Scholar 

  8. Chapuy MC, Preziosi P, Maamer M et al (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443

    Article  CAS  PubMed  Google Scholar 

  9. Bettica P, Bevilacqua M, Vago T, Norbiato G (1999) High prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient clinic in northern Italy for initial screening. Osteoporos Int 9:226–229

    Article  CAS  PubMed  Google Scholar 

  10. Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15:1856–1862

    CAS  PubMed  Google Scholar 

  11. Brot C, Vestergaard P, Kolthoff N, Gram J, Hermann AP, Sorensen OH (2001) Vitamin D status and its adequacy in healthy Danish perimenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone. Br J Nutr 86:S97–103

    CAS  PubMed  Google Scholar 

  12. Kauppinen-Makelin R, Tahtela R, Loyttyniemi E, Karkkainen J, Valimaki MJ (2001) A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients. J Int Med 249:559–563

    Article  CAS  Google Scholar 

  13. Mezquita-Raya P, Munoz-Torres M, Luna JD et al (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16:1408–1415

    CAS  PubMed  Google Scholar 

  14. Rassouli A, Milanian I, Moslemi-Zadeh M (2001) Determination of serum 25-hydroxyvitamin D(3) levels in early postmenopausal Iranian women: relationship with bone mineral density. Bone 29:428–430

    Article  CAS  PubMed  Google Scholar 

  15. Silverberg SJ, Fitzpatrick LA, Bilezikian JP (1996) The role of parathyroid hormone and vitamin D in the pathogenesis of osteoporosis. In: Marcus R, Feldman D, Kesley J (eds) (1996) Osteoporosis. Academic Press, San Diego, pp 716–726

  16. Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141

    CAS  PubMed  Google Scholar 

  17. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    CAS  PubMed  Google Scholar 

  18. Anonymous (1994) National Institute of Health Consensus Conference. Optimal calcium intake. JAMA 272:1942–1948

    PubMed  Google Scholar 

  19. Holick MF (1994) Vitamin D—new horizons for the 21st century. Am J Clin Nutr 60:619–630

    CAS  PubMed  Google Scholar 

  20. Heaney RP, Gallagher JC, Johnston CC, Neer R, Parfitt AM, Whedon GD (1982) Calcium nutrition and bone health in the elderly. Am J Clin Nutr 36:986–1013

    CAS  PubMed  Google Scholar 

  21. Krall EA, Sahyoun N, Tannenbaum S, Dallal GE, Dawson-Hughes B (1989) Effect of vitamin D intake on seasonal variations in parathyroid hormone secretion in postmenopausal women. N Engl J Med 321:1777–1783

    CAS  PubMed  Google Scholar 

  22. Lips P, Netelenbos JC, Jongen MJ et al. (1982) Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Relat Res 4:85–93

    CAS  PubMed  Google Scholar 

  23. Silverberg SJ, Shane E, de la Cruz L et al (1989) Skeletal disease in primary hyperparathyroidism. J Bone Miner Res 4:283–291

    CAS  PubMed  Google Scholar 

  24. Woitge HW, Scheidt-Nave C, Kissling C et al. (1998) Seasonal variation of biochemical indexes of bone turnover: results of a population-based study. J Clin Endocrinol Metab 83:68–75

    Google Scholar 

  25. Sahota O, Masud T, San P, Hosking DJ (1999) Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis. Clin Endocrinol (Oxf) 51:217–221

    Google Scholar 

  26. Marcus R, Madvig P, Young G (1984) Age-related changes in parathyroid hormone and parathyroid hormone action in normal humans. J Clin Endocrinol Metab 58:223–230

    CAS  PubMed  Google Scholar 

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Correspondence to A. Balogh.

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Bhattoa, H.P., Bettembuk, P., Ganacharya, S. et al. Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. Osteoporos Int 15, 447–451 (2004). https://doi.org/10.1007/s00198-003-1566-1

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  • DOI: https://doi.org/10.1007/s00198-003-1566-1

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