Vitamin D insufficiency: A risk factor to vertebral fractures in community-dwelling elderly women

Author(s)

Lopes, Jaqueline B. ^[1] ; Danilevicius, Camille F. ^[1] ; Takayama, Liliam ^[1] ; Caparbo, Valeria F. ^[1] ; Scazufca, Marcia ^[1] ; Bonfa, Eloisa ^[1] ; Pereira, Rosa M. R. ^[2]

Affiliation

^[1] Univ Sao Paulo, Fac Med, Bone Metab Lab, Div Rheumatol, BR-01246903 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Lab Metab Osseo LIM 17, Disciplina Reumatol, FMUSP, Dept Psychiat, Sect Epid, BR-01246903 Sao Paulo - Brazil

• Document type: Journal article
• Source: MATURITAS; v. 64, n. 4, p. 218-222, DEC 20 2009.
• Web of Science Citations: 24

Abstract

Objective:To determine the risk factors for the presence of moderate/severe vertebral fracture, specifically 25-hydroxyvitamin D (25-OHD). Study design: Cross-sectional study conducted for 2 years in the city of Sao Paulo, Brazil including community-dwelling elderly women. Methods: Bone mineral density (BMD), serum 25-OHD, intact parathyroid hormone (iPTH), calcium and estimated glomerular filtration rate (eGFR) were examined in 226 women without vertebral fractures (NO FRACTURE group) and 189 women with at least one moderate/severe vertebral fracture (FRACTURE group). Vertebral fracture assessment (VFA) was evaluated using both the Genant semiquantitative (SQ) approach and morphometry. Results: Patients in the NO FRACTURE group had lower age, increased height, higher calcium intake, and higher BMD compared to those patients in the FRACTURE group (p < 0.05). Of interest, serum levels of 25-OHD in the NO FRACTURE group were higher than those observed in the FRACTURE group (51.73 nmol/L vs. 42.31 nmol/L, p < 0.001). Reinforcing this finding, vitamin D insufficiency (25-OHD < 75 nmol/L) was observed less in the NO FRACTURE group (82.3% vs. 93.65%, p = 0.001). After adjustment for significant variables within the patient population (age, height, race, calcium intake, 25-OHD, eGFR and sites BMD), the logistic-regression analyses revealed that age (OR = 1.09, 95% Cl 1.04-1.14, p < 0.001) femoral neck BMD (OR = 0.7, 95% CI 0.6-0.82, p < 0.001) and 25-OHD <75 nmol/L (OR = 2.38, 95% CI 1.17-4.8, p = 0.016) remains a significant factor for vertebral fracture. Conclusion: Vitamin D insufficiency is a contributing factor for moderate/severe vertebral fractures. This result emphasizes the importance of including this modifiable risk factor in the evaluation of elderly women. (C) 2009 Elsevier Ireland Ltd. All rights reserved. (AU)

• FAPESP's process: 03/09313-0 - Prevalence of osteoporosis, vertebral and non-vertebral fractures in a female population aged 65 or older in the Butantã area
• Grantee: Rosa Maria Rodrigues Pereira
• Support Opportunities: Regular Research Grants
• FAPESP's process: 04/12694-8 - Incidence of dementia and cognitive decline in low-income elderly in São Paulo: a cohort study
• Grantee: Isabela Judith Martins Bensenor
• Support Opportunities: Regular Research Grants