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Vitamin D status: effects on quality of life in osteoporosis among Turkish women

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Abstract

Background and objectives

Vitamin D deficiency causes muscle weakness, impairs bone formation and neuromuscular coordination thus leading to an increase in fracture risk. It has been found that inadequate levels of vitamin D are present in most of the osteoporosis patients. However, very few studies investigate the association between vitamin D status and quality of life (QOL). The aim of this study is to investigate the effects of vitamin D on QOL among Turkish women with osteoporosis.

Methods

259 patients (61.0 ± 8.9 years) with osteoporosis were evaluated by physical activity level, back pain, bone turnover markers, 25-hydroxyvitamin D [25(OH)D], parathyroid hormone levels and bone mineral density. QOL was assessed using QOL Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). 25(OH)D levels below 20 ng/ml was defined as vitamin D insufficiency, below 12 ng/ml as vitamin D deficiency.

Results

Mean 25(OH)D level was 22.7 ± 12.6 ng/ml and mean total QUALEFFO score was 43.3 ± 14.9. Vitamin D levels were significantly correlated with all subscales and total score of QUALEFFO (r = −0.25, P = 0.0001). Vitamin D insufficiency was determined in 132 patients (51%). In vitamin D deficient (<12 ng/ml) group all subscales and total QOL were found to be poorer when compared with the groups whose vitamin D levels were ≥12 and <20 ng/ml and ≥20 ng/ml (effect sizes 0.41 and 0.62 respectively, P = 0.0001 for total QOL). Vitamin D level, education, concomitant diseases, physical activity level and pain severity were found to be significantly associated with QOL in multiple linear regression analysis model.

Conclusions

Vitamin D insufficiency affects physical, social and mental functions of osteoporosis patients and impairs QOL. Vitamin D was found to be one of the factors affecting QOL.

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Abbreviations

QOL:

Quality of life

25(OH)D:

25-Hydroxyvitamin D

BMD:

Bone mineral density

BMI:

Body mass index

VAS:

Visual analogue scale

PTH:

Parathyroid hormone

SDI:

Spinal deformity index

DEXA:

Dual energy X-Ray absorbtiometry

QUALEFFO:

Quality of Life Questionnaire of the European Foundation for Osteoporosis

References

  1. Geusens, P. (2003). Osteoporosis: Clinical features. In M. Hochberg, A. J. Silman, & J. S. Smolen (Eds.), Rheumatology (pp. 2081–92). Toronto: Mosby.

    Google Scholar 

  2. Francis, R. M. (2001). Falls and fractures. Age and Ageing, 30(Suppl 4), 25–28.

    Google Scholar 

  3. Lips, P., & van Schoor, N. M. (2005). Quality of life in patients with osteoporosis. Osteoporosis International, 16, 447–455.

    Article  PubMed  Google Scholar 

  4. Mosekilde, L. (2005). Vitamin D and the elderly. Clinical Endocrinology, 62, 265–281.

    Article  PubMed  CAS  Google Scholar 

  5. Reginster, J. Y. (2005). The high prevalence of inadequate serum vitamin D levels and implications for bone health. Current Medical Research and Opinion, 21(4), 579–585.

    Article  PubMed  CAS  Google Scholar 

  6. Zittermann, A. (2003). Vitamin D in preventive medicine: Are we ignoring the evidence? The British Journal of Nutrition, 89, 552–572.

    Article  PubMed  CAS  Google Scholar 

  7. Janssen, H. C. J. P., Samson, M. M., & Verhaar, H. J. J. (2002). Vitamin D deficiency, muscle function, and falls in elderly people. The American Journal of Clinical Nutrition, 75, 611–615.

    PubMed  CAS  Google Scholar 

  8. Montero-Odasso, M., & Duque, G. (2005). Vitamin D in the aging musculoskeletal system: An authentic strength preserving hormone. Molecular Aspects of Medicine, 26, 203–219.

    Article  PubMed  CAS  Google Scholar 

  9. Dhesi, J. K., Jackson, S. H. D., Bearne, L. M., Moniz, C., Hurley, M. V., Swift, C. G., et al. (2004). Vitamin D supplementation improves neuromuscular function in older people who fall. Age and Ageing, 33, 589–595.

    Article  PubMed  Google Scholar 

  10. Di Monaco, M., Vallero, F., Di Monaco, R., Mautino, F., & Cavanna, A. (2005). Serum levels of 25-hydroxyvitamin D and functional recovery after hip fracture. Archives of Physical Medicine and Rehabilitation, 86, 64–68.

    Article  PubMed  Google Scholar 

  11. Chapuy, M. C., Preziosi, P., Maamer, M., Arnaud, S., Galan, P., Hercberg, S., et al. (1997). Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis International, 7, 439–443.

    Article  PubMed  CAS  Google Scholar 

  12. Sharla, S. H. (1998). Prevalence of subclinical vitamin D deficiency in different European countries. Osteoporosis International (Suppl 8), S7–S12.

  13. Need, A. G., Horowitz, M., Morris, H. A., & Nordin, B. E. C. (2000). Vitamin D status: Effects on parathyroid hormone and 1,25-dihydroxyvitamin D in postmenopausal women. American Journal of Clinical Nutrition, 71, 1577–1581.

    PubMed  CAS  Google Scholar 

  14. Hanley, D. A., & Davison, S. (2005). Vitamin D insufficiency in North America. Journal of Nutrition, 135, 332–337.

    PubMed  CAS  Google Scholar 

  15. Pfeifer, M., Begerow, B., & Minne, H. W. (2002). Vitamin D and muscle function. Osteoporosis International, 13, 187–194.

    Article  PubMed  CAS  Google Scholar 

  16. Lips, P. (2004). Which circulating level of 25-hydroxyvitamin D appropriate? The Journal of Steroid Biochemistry and Molecular Biology, 89–90(1–5), 611–614.

    Article  PubMed  Google Scholar 

  17. Brown, J. P., Josse, R. G., & the Scientific Advisory Council of the Osteoporosis Society of Canada. (2002). 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ, 167(10 Suppl), S1–S34.

    PubMed  Google Scholar 

  18. Genant, H. K., & Jergas, M. (2003). Assessment of prevalent and incident vertebral fractures in osteoporosis research. Osteoporosis International, 14(Suppl 3), S43–S55.

    PubMed  Google Scholar 

  19. Crans, G. G., Genant, H. K., & Krege, J. H. (2005). Prognostic utility of a semiquantitative spinal deformity index. Bone, 37(2), 175–179.

    Article  PubMed  Google Scholar 

  20. Koçyiğit, H., Gülseren, Ş., Erol, A., Hizli, N., & Memis, A. (2003). The reliability and validity of the Turkish version of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Clinical Rheumatology, 22, 18–23.

    Article  PubMed  Google Scholar 

  21. Lips, P., Cooper, C., Agnusdei, D., Caulin, F., Egger, P., Johnell, O., et al. (1999). Quality of life in patients with vertebral fractures: Validation of the quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporosis International, 10, 150–160.

    Article  PubMed  CAS  Google Scholar 

  22. Silverman, S. L. (2005). Quality-of-life issues in osteoporosis. Current Rheumatology Reports, 7(1), 39–45.

    Article  PubMed  Google Scholar 

  23. Kessenich, C. R., Guyatt, G. H., & Rosen, C. J. (1998). Health-related quality of life and participation in osteopororsis clinical trials. Calcified Tissue International, 62, 189–192.

    Article  PubMed  CAS  Google Scholar 

  24. Bianchi, M. L., Orsini, M. R., Saraifoger, S., Ortolani, S., Radaelli, G., & Betti, S. (2005). Quality of life in post-menopausal osteoporosis. Health and Quality of Life Outcomes, 3, 78. Retrieved May 1, 2006, from http://www.hqlo.com/content/3/1/78.

  25. Holick, M. F., Siris, E. S., Binkley, N., Beard, M. K., Khan, A., Katzer, J. T., et al. (2005). Prevalance of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. Journal of Clinical Endocrinology Metabolism, 90, 3215–3224.

    Article  PubMed  CAS  Google Scholar 

  26. Gaugris, S., Heaney, R. P., Bonen, S., Kurth, H., Bentkover, J. D., & Sen, S. S. (2005). Vitamin D inadequacy among post-menopausal women: A systematic review. QJM, 98(9), 667–676.

    Article  PubMed  CAS  Google Scholar 

  27. Hollis, B. W. (2005). Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: Implications for establishing a new effective dietary intake recommendation for vitamin D. Journal of Nutrition, 135, 317–322.

    PubMed  CAS  Google Scholar 

  28. Vieth, R., Cole D. E., Hawker, D. A., Trang, H. M., & Rubin, L. A. (2001). Wintertime Vitamin D insufficiency is common in young Canadian women and their vitamin D intake does not prevent it. European Journal of Clinical Nutrition, 55, 1091–1097.

    Article  PubMed  CAS  Google Scholar 

  29. Heaney, R. P., Davies, K. M., Chen, T. C., Holick, M. F., & Barger-Lux, M. J. (2003). Human serum 25-hydroxycholecalciferol response to extended dosing with cholecalciferol. American Journal of Clinical Nutrition, 77, 204–210.

    PubMed  CAS  Google Scholar 

  30. Gerdheim, P., Ringsberg, K. A. M., Obrant, K. J., & Akesson, K. (2005). Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA study of elderly women. Osteoporosis International, 16, 1425–1431.

    Article  Google Scholar 

  31. Di Monaco, M., Vallero, F., Di Monaco, R., Tappero, R., & Cavanna, A. (2006). 25-hydroxyvitamin D, parathyroid hormone, and functional recovery after hip fracture in elderly patients. Journal of Bone and Mineral Metabolism, 24, 42–47.

    Article  PubMed  CAS  Google Scholar 

  32. Porthouse, J., Cockayne, S., King, C., Saxon, L., Steele, E., Aspray, T., et al. (2005). Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ, 330, 1003–1007.

    Article  PubMed  CAS  Google Scholar 

  33. Harris, S., & Dawson-Hughes, B. (1993). Seasonal mood changes in 250 normal women. Psychiatry Research, 49(1), 77–87.

    Article  PubMed  CAS  Google Scholar 

  34. Gloth, F. M., Alam, W., & Hollis, B. (1999). Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. The Journal of Nutrition, Health and Aging, 3(1), 5–7.

    Google Scholar 

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Acknowledgement

We thank Gulsah Seydaoglu, MD, PhD for her valuable contribution with the statistical analysis.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Cukurova University, Adana, 01330, Turkey

    Sibel Basaran, Rengin Guzel, Ilke Coskun-Benlidayi & Fusun Guler-Uysal

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  1. Sibel Basaran
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  2. Rengin Guzel
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  3. Ilke Coskun-Benlidayi
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Correspondence to Sibel Basaran.

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Basaran, S., Guzel, R., Coskun-Benlidayi, I. et al. Vitamin D status: effects on quality of life in osteoporosis among Turkish women. Qual Life Res 16, 1491–1499 (2007). https://doi.org/10.1007/s11136-007-9257-6

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  • DOI: https://doi.org/10.1007/s11136-007-9257-6

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