Ankara Bölgesinde Yaşayan Postmenapozal Kadınlarda D Vitamini Eksikliği Görülme Oranı
Amaç: Ankara Üniversitesi Tıp Fakültesi Dahiliye Polikliniklerine başvuran postmenapozal kadınlarda D vitamini eksikliği sıklığının ve kemikmetabolizması üzerine olan etkilerinin belirlenmesi.Gereç ve Yöntem: Çalışma kesitsel bir çalışma olarak düzenlendi. Postmenapozal 131 kadın Dexa ile taranarak osteoporoz, osteopeni ve kontrolgrubu olarak üçe ayrıldı. Hasta viziti sırasında hastaların giyimleri ve günlük aldıkları güneş ışığı miktarı 1’den 4’e kadar skorlandı. Bu kadınlarda Dvitamini, Paratiroid hormon (PTH), osteokalsin, Bağımlı kişilik bozukluğu (DPD), kalsiyum, fosfor, Alkalin fosfataz (ALP) seviyeleri karşılaştırıldı.Bulgular: Kadınların %29,8’inde osteoporoz, %45,8’inde osteopeni saptandı. Kırk sekiz kadında (%36,6) ağır D vitamini eksikliği (25-OH-D
Frequency of Vitamin D Deficiency in Postmenopausal Women Who Live in Ankara Region
Objectives: The aim of this study is to define the frequency of vitamin D deficiency in postmenopausal women and to evaluate its implications on bone metabolism. Patients, who admitted to the Ankara University Faculty of Medicine Outpatient Clinics included to the study. Materials and Methods: The study was conducted as a cross-sectional study. Postmenopausal women were scanned with DEXA and divided into three groups as osteoporosis, osteopenia, and the control group according to the T scores. During medical visit, patients’ clothing habits, and daily sunlight exposure rates have been scored from 1 to 4 with a questionnaire. Vitamin D, Parathyroid hormone (PTH), osteocalcin, Dependent personality disorder (DPD), calcium, phosphorus, Alkaline phosphotase (ALP) levels were compared. Results: 29.8% of the women had osteoporosis, and 45.8% had osteopenia. Forty eight women (36.6%) were reported to have severe vitamin D deficiency (25-OH-D
___
- 1. 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. 2006;260:245-254.
- 2. Neuprez A, Bruyère O, Collette J, et al.Vitamin D inadequacy in Belgian
postmenopausal osteoporotic women. BMC Public Health. 2007;7:64.
- 3. Sahota O, Mundey MK, San P, et al. The relationship between vitamin D
and parathyroid hormone: calcium homeostasis, bone turnover, and bone
mineral density in postmenopausal women with established osteoporosis.
Bone. 2004;35:312-319.
- 4. González G, Alvarado JN, Rojas A, et al. High prevalence of vitamin D
deficiency in Chilean healthy postmenopausal women with normal sun
exposure: additional evidence for a worldwide concern. Menopause.
2007;14:455-461.
- 5. Bruyère O, Malaise O, Neuprez A, et al. Prevalence of vitamin D inadequacy
in European postmenopausal women. Curr Med Res Opin. 2007;23:1939-
1934.
- 6. Bandeira F, Griz L, Dreyer P, et al. Vitamin D deficiency: A global perspective.
Arq Bras Endocrinol Metabol. 2006;50:640-646.
- 7. Hill TR, O’Brien MM, Lamberg-Allardt C, et al. Vitamin D status of
51-75-year-old Irish women: its determinants and impact on biochemical
indices of bone turnover. Public Health Nutr. 2006;9:225-233.
- 8. Ono Y, Suzuki A, Kotake M, et al. Seasonal changes of serum
25-hydroxyvitamin D and intact parathyroid hormone levels in a normal
Japanese population.J Bone Miner Metab. 2005;23:147-151.
- 9. Levis S, Gomez A, Jimenez C, et al. Vitamin d deficiency and seasonal
variation in an adult South Florida population. J Clin Endocrinol Metab.
2005;90:1557-1562.
- 10. Need AG, O’Loughlin PD, Morris HA, et al. The effects of age and other
variables on serum parathyroid hormone in postmenopausal women
attending an osteoporosis center. J Clin Endocrinol Metab. 2004;89:1646-
1649.
- 11. Garnero P, Munoz F, Sornay-Rendu E, et al. Associations of vitamin D status
with bone mineral density, bone turnover, bone loss and fracture risk in
healthy postmenopausal women. The OFELY study. Bone. 2007;40:716-722.
- 12. Raisz LG. Pathogenesis of osteoporosis: concepts, conflicts, and prospects. J
Clin Invest. 2005;115:3318-3325.
- 13. Bhattoa HP, 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.
2004;15:447-451.
- 14. Melin A, Wilske J, Ringertz H, et al. Seasonal variations in serum levels of
25-hydroxyvitamin D and parathyroid hormone but no detectable change
in femoral neck bone density in an older population with regular outdoor
exposure. J Am Geriatr Soc. 2001;49:1190-1196.
- 15. Tuzun S, Eskiyurt N, Akarirmak U, et al. Turkish Osteoporosis Society.
Incidence of hip fracture and prevalence of osteoporosis in Turkey: the
FRACTURK study. Osteoporos Int. 2012;23:949-955.
- 16. Öğüş E , Sürer H, Kılınç ŞA, et al. D Vitamini Düzeylerinin Aylara, Cinsiyete
ve Yaşa Göre Değerlendirilmesi. Ankara Med J. 2015;15:1-5.
- 17. Atli T, Gullu S, Uysal AR, et al. The prevalence of Vitamin D deficiency and
effects of ultraviolet light on Vitamin D levels in elderly Turkish population.
Arch Gerontol Geriatr. 2005;40:53-60.
- 18. Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in
medical inpatients . N Engl J Med. 1998;338:777-783.
- 19. Michaelsson K, Wolk A, Byberg L, et al.The seasonal importance of serum
25-hydroxyvitamin D for bone mineral density in older women. J Intern
Med. 2017;281:167-178.
- 20. Saraiva GL, Cendoroglo MS, Ramos LR, et al. Influence of ultraviolet radiation
on the production of 25 hydroxyvitamin D in the elderly population in the city
of São Paulo (23 degrees 34’S), Brazil Osteoporos Int. 2005;16:1649-1654.
- 21. Adami S, Isaia G, Luisetto G, et al. ICARO Study Group Fracture incidence
and characterization in patients on osteoporosis treatment: the ICARO
study. J Bone Miner Res. 2006;21:1565-1570.
- 22. Jackson C, Gaugris S, Sen SS, et al. The effect of cholecalciferol (vitamin D3)
on the risk of fall and fracture: a meta-analysis. QJM. 2007;100:185-192.
- 23. Rizzoli R, Eisman JA, Norquist J, et al. Risk factors for vitamin D inadequacy
among women with osteoporosis: an international epidemiological study.
Int J Clin Pract. 2006;60:1013-1019.
- 24. Arantes HP, Kulak CA, Fernandes CE, et al. Correlation between
25-hydroxyvitamin D levels and latitude in Brazilian postmenopausal
women: from the Arzoxifene Generations Trial. Osteoporos Int.
2013;24:2707-2712.
- 25. Cummings SR , Melton LJ 3rd. Epidemiology and outcomes of osteoporotic
fractures. Lancet. 2002;359:1761-1767.
- 26. Melton LJ 3rd . How many women have osteoporosis now?. J Bone Miner
Res. 1995;10:175-177.
- 27. WHO Technical Report Series. Research on the Menopause in 1990s . Report
of a wWHO Scientific Group 1994.
- 28. Lips P, Duong T, Oleksik A, et al. A global study of vitamin D status and
parathyroid function in postmenopausal women with osteoporosis: baseline
data from the multiple outcomes of raloxifene evaluation clinical trial. J
Clin Endocrinol Metab. 2001;86:1212-1221.
- 29. 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. 2005;90:3215-3224.
- 30. Van Schoor NM, Visser M, Pluijm SM, et al. Vitamin D deficiency as a risk
factor for osteoporotic fractures. Bone. 2008;42:260-266.
- 31. Xie Z, Xia W, Zhang Z, et al. Prevalence of Vitamin D Inadequacy Among
Chinese Postmenopausal Women: A Nationwide, Multicenter, Cross-
Sectional Study. Front Endocrinol (Lausanne). 2019;9:782.
- 32. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in
the elderly: consequences for bone loss and fractures and therapeutic
implications. Endocr Rev. 2001;22:477-501.
- 33. Budak N, Çiçek B,Şahin H, et al. Bone mineral density and serum 25-
hydroxyvitamin D level: is there any difference according to the dressing
style of the female university students ? International Journal of Food
Sciences and Nutrition, 2004;55:569-575.
- 34. Güler T, Sivas F, Başkan BM, ve ark. The effect of outfitting style on bone
mineral density.Rheumatol Int. 2007;27:723-727.
- 35. Hayirlioglu DA, Gokaslan H, Cimsit C, ve ark. The impact of clothing
style on bone mineral density among women in Turkey. Rheumatol Int.
2008;28:521–525.
- 36. Guzel R, Kozanoglu, ED, Guler-Uysal F, et al. Vitamin D Status And Bone
Mineral Density Of Veiled And Unveiled Turkish Women. Journal Of
Women’s Health & Gender-Based Medicine 2001;10
- 37. Napoli N, Strollo R, Sprini D, et al. Serum 25-OH Vitamin D in relation to Bone
Mineral Density and Bone Turnover. Int J Endocrinol. 2014;2014:487463.
- 38. Need AG, Horowitz M, Morris HA, et al. Vitamin D status: effects on
parathyroid hormone and 1, 25-dihydroxyvitamin D in postmenopausal
women. Am J Clin Nutr. 2000;71:1577-1581.