HYPOVITAMINOSIS D IN TUNISIAN OSTEOPOROTIC POST MENOPAUSAL WOMEN AND ITS RELATIONSHIP WITH BONE FRACTURE
##plugins.themes.academic_pro.article.main##
Abstract
Aim : The purpose of this study is to evaluate the frequency of hypovitaminosis D in Tunisian osteoporotic women and to search an eventual association between vitamin D status and the fracture risk.
Methods: A transverse descriptive study enrolled 134 osteoporotic menopausal women aged 50 years or more. We measured calcium, phosphorus, albumin, alkaline phosphatase, creatinine and 25 hydroxyvitamin D [25 (OH) vit D]. Bone mineral density (BMD) was measured for all and osteoporotic women were defined for a Tscore of –2,5 or less in the spine, hip or femoral neck.Two groups were defined: G1 with fracture and G2 without fracture.We used SPSS 10.5, X2 tests and a statistical significance level of p< 0,05.
Results: Women in G1 (n= 102) were more aged than those in G2 (n= 32) and their menopause was more ancient. Hypovitaminosis D was found in 45,2% of all women, respectively in 50,98% of G1 and 25% of G2. The mean level of vitamin D was more important in G2 (27,5+ 15,1 vs 21,3 + 12,8 ng/ml ; p=0,002) BMD in femoral and lumbar were statistically lower when fractures are present (p< 0,001)
Conclusion: Our study shows that women with hypovitaminosis D (vit D < 20 ng/ml) are prone to osteoporotic fractures. All fracture in community in menopausal women, should be assessed with BMD and screening for 25 (OH) vit D. Increasing life expectancy in our country suggests that this public health problem will grow in the years to come, pointing out the importance of better management of osteoporosis and hypovitaminosis D to prevent fractures.
Keywords:
Osteoporosis, Hypovitaminosis D, Bone mineral density, Menopause, fracture##plugins.themes.academic_pro.article.details##
References
- Sellami S, Sahli H, Meddeb N et al. Prevalence of osteoporotic fractures in Tunisian women. Rev Chir Orthop Reparatrice Appar Mot 2006; 92:490-4.
- Honkanen RJ, Honkanen K, Kröger H, Alhava E, Tuppurainen M, Saarikoski S. Risk factors of perimenopausal distal forearm fracture. Osteoporos Int 2000; 11: 265-70.
- Sornay-Rendu E, Munoz F, Garnero P, Duboeuf F, Delmas PD. Identification of osteopenic women at high risk of fracture: the OFELY study. J Bone Miner Res 2005;20:1813-9.
- Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S. Prevalence of hypovitaminosis D in elderly women in Italy: clinical consequences and risk factors. Osteoporos Int 2003;14:577-82.
- Melton LJ 3rd, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL. Epidemiology of vertebral fractures in women. Am J Epidemiol 1989; 129: 1000-11.
- Mezquita-Raya P, Munoz-Torres M, Luna JD et al. Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy post menopausal women. J Bone Miner Res 2001;16:1408-15.
- Seton M, Jackson V, Lasser KE, Doppelt S, Pierre-Jaques M, Connelly M ,et al. Low 25-hydroxyvitamin D and osteopenia are prevalent in persons >or = 50 yr with fracture at any site: a prospective, observational study of persons fracturing in the community. J Clin Densitom 2005 ; 8: 454-60.
- Meddeb N, Sahli H, Chahed M et al. Vitamin D deficiency in Tunisia. Osteoporos Int 2005;16:180-3.
- Gannagé Yared MH, Chemali R, Yaacoub N, Halaby G. Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 2000;15:1856-62.
- Need AG. Bone resorption markers in vitamin D insufficiency. Clin Chim Acta 2006; 368:48-52.