Vitamin D deficiency and osteoporosis en a rural population of Cordoba province, Argentina
DOI:
https://doi.org/10.31053/1853.0605.v66.n3.23461Keywords:
vitamin D deficiency, osteoporosis, rural populationsAbstract
Introduction: Vitamin D deficiency is defined when blood levels of 25-hydroxyvitamin D (25 (OH) D) is less than 20 ng / mmol/L. The status of Vitamin D level is associated with clinical, pathological and physiological changes as increased of parathyroid hormone, bone remodeling, osteoporosis and increased risk of fractures. Moreover, vitamin D and its metabolites are known to be associated with multiple chronic diseases as diabetes mellitus, autoimmune, cardiovascular and neoplasia diseases. Objective: To assess the vitamin D status in a rural population of Córdoba Province in Argentina and its relation with bone mineral density.
Material and Methods: We prospectively studied 31 patients over 50 years old who live in a rural population of Pampa de Achala in Córdoba Province, Argentina. This city is located in Córdoba High mountains. Blood vitamin D levels were tested in 24 patients and Bone mineral density in 31 patients. Vitamin D level was determined by HPLC. The vitamin D level were considered normal between 20-50 ng/ml in the winter season and 20-80 ng/ml in the summer season. Bone mineral density of lumbar spine and femoral neck was measured by DXA GE LUNAR DPX-L, according to World Health organization classification (37).
The data were analyzed by Spearman coeficient and Chi cuadrado.
Results: The vitamin D levels samples were avaliable in 24 patients. Mean blood Vitamin D level was 24.54 ng /ml. 8 of them (33%) had vitamin D level less than 20ng/ ml. 83% (20) of the analysed patients had vitamin D level less than 30 ng/ml and only 4 patients has vitamin D level more than 30 ng/ml.
Low bone mineral density of lumbar spine and femoral neck was found in 66 % of the patients. 19 % of the patients were diagnosed of lumbar spine and femoral neck osteoporosis and 29% of them had lumbar spine meanwhile 25% had femoral neck. There was not statistically significant associaton between vitamin D level and bone mineral density analysed by Chi Cuadrado (p<0.07). A significant association was found between blood vitamin D level and low bone mineral density of femoral neck (Spearman 0.51)
Conclusions: Vitamin D insufficiency is high in the rural adult population of Pampa de Achala in Córdoba and it could be a major health problem in this population.
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References
Bickle, D What is new in Vitamin D 2006-2007. Curr Opin Rheumatol 19:383–388.2007 [Abstract]
Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr; 84:1253. 2006 [Full Text]
Bakhtiyarova S, Lesnyak O, Kyznesova N, Blankenstein MA, Lips P. Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporos Int; 17:441-6. 2006 [Abstract]
Boonen S, Bischoff-Ferrari HA, Cooper C, et al. Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence. Calcif Tissue Int; 78:257-70. 2006 [Abstract]
Canhao, H Vitamina D- Aplicacoes e perspectivas. Acta Reum Port; 32: 201-203.
Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ: Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 327:1637–1642, 1992. [Full Text]
Chapuy MC, Preziosi P, Maamer M, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int; 7:439-43. 1997 [Abstract]
Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int; 16:713-6. 2005 [Full Text]
El-Hajj Fuleihan G, Nabulsi M, Choucair M, et al. Hypovitaminosis D in healthy schoolchildren. Pediatrics; 107:E53. 2001 [Full Text]
Ghannam NN, Hammami MM, Bakheet SM, Khan BA. Bone mineral density of the spine and femur in healthy Saudi females: relation to vitamin D status, pregnancy, and lactation. Calcif Tissue Int. Jul; 65(1):23-8. 1999 [Abstract]
Glerup H, Mikkelsen K, Poulsen L, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med; 247:260-8. 2000 [Abstract]
Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents.Arch Pediatr Adolesc Med; 158:531-7. 2004
Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr; 22:142-6. 2003
Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc; 81:353-73. 2006
Holick MF, Siris ES, Binkley N, et al. Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab; 90:3215-24. 2005
Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest; 116:2062-72. 2006
Holick, M Vitamin D Deficiency N Engl J Med;357:266-81. 2007
Jackson SA, Tenenhouse A, Robertson L. Vertebral fracture definition from population-based data: preliminary results from the Canadian Multi Center Osteoporosis Study. Osteoporos Int 11:680–687. 2000
Jackson, R et al Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med; 354; 7, 669-83. 2006
Larsen ER, Mosekilde L, Foldspang A. Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population-based 3-year intervention study. J Bone Miner Res; 19:370-8. 2004
Lee JM, Smith JR, Philipp BL, Chen TC, Mathieu J, Holick MF. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila); 46:42-4. 2007
Lips P, Hosking D, Lippuner K, et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med; 260:245-54. 2006
Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev; 22:477-501. 2001
Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet; 351:805-6. 1998
Marwaha RK, Tandon N, Reddy D, et al. Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr; 82:477-82. 2005
McGrath JJ, Kimlin MG, Saha S, Eyles DW, Parisi AV. Vitamin D insufficiency in south-east Queensland. Med J Aust; 174:150-1. 2001
McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med; 93:69-77. 1992
Nesby-O’Dell S, Scanlon KS, Cogswell ME, et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr; 76:187-92. 2002
Olivieri, B; Plantalech, L; et al Elevada incidencia de insuficiencia de vitamina D en los adultos sanos mayores de 65 años en diferentes regiones de la argentina. Comisión de Investigación de la Asociación Argentina de Osteología y Metabolismo Mineral. Actualizaciones en Osteología 1: 40-46, 2005
Pettifor JM. Vitamin D deficiency and nutritional rickets in children in vitamin D. In: Feldman D, Pike JW, Glorieux FH, eds. Vitamin D. 2nd ed. Boston: Elsevier Academic Press, 1065-84. 2005
Prior JC, Vigna YM, Schechter MT, et al. Spinal bone loss and ovulatory disturbances. N Engl J Med; 323:1221. 1990
Sedrani SH. Low 25-hydroxyvitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region. Ann Nutr Metab; 28: 181-5. 1984
Spindler A, Lucero E, Berman A, Paz S, Vega E, Mautalen C. Bone mineral density in a native population of Argentina with low calcium intake. J Rheumatol; 22: 2148-51. 1995
Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med; 112: 659-62. 2002
Thomas KK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J Med; 338:777-83. 1998
Vieth R. Why the optimal requirement for vitamin D3 is probably much higher than what is officially recommended for adults. J Steroid Biochem Mol Biol; 89-90:575-9. 2004
WHO (1994). «Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group». World Health Organization technical report series 843: pp. 1–129. 1994
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