Association of bone mineral density and vitamin D levels in postmenopausal women in Ankara
Amaç: D vitamini, kemik mineralizasyonu için gerekli olup, eksikliğinde osteoporoz, rikets, osteomalazi ve kemik kırıkları oluşabilmektedir. Postmenopozal kadınlarda, fizyolojik olarak hem östrojen hormonu düzeyinin azalması, hem de yaşa bağlı kemik mineral dansitesinde azalma olmaktadır. Postmenopozal kadınlarda kemik sağlığını etkileyebilecek faktörlerin birden fazla olması nedeniyle, D vitamini düzeyleri ve kemik sağlığı arasındaki ilişkinin belirlenebilmesi zordur. Bu nedenle araştırmamızda Ankara şehir merkezinde yaşayan, ev hanımı, menopoz sonrası kadınlarda D vitamini düzeyini ve D vitamininin kemik mineral dansitesi ile arasındaki ilişkiyi belirlemek istedik. Materyal ve Metot: 2012 yaz döneminde Ankarada yaşayan, yaş ortalaması 59,7±9,2 olan, güneş ışığına yeterince maruz kalabilecek şekilde giyinen 223 post- menopozal kadın çalışmaya dahil edildi. Vitamin D, kalsiyum, parathormon, fosfor, kemik tara-ması ve genel laboratuar testleri değerlendirildi. Bulgular D vitamini ortalaması 27,4±21,3 ng/ml olarak saptandı. Osteopenik ve osteoporotik olan gruba göre kıyaslandığında normal kemik dansitometrisi olanlarda D vitamini düzeyleri daha yüksekti (p0,05). Sonuçlar: Sağlıklı kemik mineralizasyonu için, postme- nopozal kadınlar mutlaka D vitamini açısından kontrol edilmeli ve eksikliği durumunda gerekli takviye verilmelidir.
Ankarada yaşayan postmenopozal ev hanımlarına kemik mineral dansitesi ve D vitamini arasındaki ilişkinin açıklanması
Background: It is known that bone mineral density changes with sexual hormone levels and age in postmenopausal women. Introduction: The association between vitamin D levels and bone mineralization in postmenopausal women is not completely understood. Our study aimed to determine the levels of vitamin D in postmenopausal women and their association with bone mineral density. Material and Methods: In summer 2012, 223 postmenopausal housewives (mean age 59.7±9.2) living in Ankara and dressing in a manner such that they could be exposed to sufficient sunlight were included in the study. Vitamin D levels, bone density, serum calcium, phosphorus, magnesium, parathyroid hormone (iPTH), alkaline phosphatase, fasting glucose, lipid profile and thyroid function tests were performed and analysed. Systolic and diastolic blood pressure measurements, exercise, daily sunshine exposure, body mass index and duration of menopause were recorded and associations of these parameters to vitamin D were assessed. Results: The mean level of vitamin D of the cases was found to be 27.4±21.3 ng/ml. The vitamin D level was found to be higher in the group with normal bone densitometry compared to the osteopenic and osteopo- rotic groups (p<0.05). No difference was found between femur neck density and vertebral density in respect to vitamin D levels (p>0.05). Conclusions: To ensure bone mineralization, vitamin D levels of postmenopausal women must be analysed routinely and vitamin D must be supplemented.
___
- 1. Heath DA, Shaw NJ. Calcium and bone metabolism. Ed: Brook CGD, Hindmarsch PC, Clinical Pediatric Endocrinology. Oxford. Blackwell Science Press 2001;pp:377-89, Oxford, ABD.
- 2. Mezquita-Raya P, Munoz-Torres M, Luna JD, et al. Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 2001;16:1408-15.
- 3. Malavolta N, Pratelli L, Frigato M, Mule R, Mascia ML, Gnudi S. The relationship of vitamin D status to bone mineral density in an Italian population of postmenopausal women. Osteoporos Int 2005;16:1691-7.
- 4. Garnero P, Munoz F, Sornay-Rendu E, Delmas PD. 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;40:716-22.
- 5. Sakuma M, Endo N, Oinuma T, et al. Vitamin D and intact PTH status in patients with hip fracture. Osteoporos Int 2006;17:1608-14.
- 6. 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;86:1212-21.
- 7. Neuprez A, Bruyere O, Collette J, Reginster JY. Vitamin D inadequacy in Belgian postmenopausal osteoporotic women. BMC Public Health 2007;7: 64.
- 8. Nakamura K, Tsugawa N, Saito T, et al. Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi Study. Bone 2008;42:271-7.
- 9. Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr 2003;89:552-72.
- 10. Kudlacek S, Schneider B, Peterlik M, et al. Assessment of vitamin D and calcium status in healthy adult Austrians. Eur J Clin Invest 2003;33: 323-31.
- 11. 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.
- 12. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81.
- 13. Hashemipour S, Larijani B, Adibi H, et al. The status of biochemical parameters in varying degrees of vitamin D deficiency. J Bone Miner Metab 2006;24:213-8.
- 14. Francisco B, Luiz G, Patricia D, Catia E, Cristina F. Vitamin D defficiency: A global perspective. Arq Bras Endoc Metab 2006;50:640-6.
- 15. van der Wielen RP, Lowik MR, van den Berg H, de Groot LC, Haller J, Moreiras O, et al. Serum vitamin D concentrations among elderly people in Europe. Lancet 1995;346:207-10.