Stephanie Doyle

May 19, 2008

May 19, 2008 (Orlando, Florida) — A new study shows that a proactive vitamin D treatment plan should be considered when caring for all osteoporosis patients, and that such treatment might help decrease the likelihood of developing vitamin D deficiency.

Vitamin D deficiency is widespread among patients being treated for osteoporosis, and such deficiency should be treated aggressively, according to the findings presented here at the American Association of Clinical Endocrinologists 17th Annual Meeting and Clinical Congress.

"Our research suggests that vitamin D deficiency is quite prevalent in patients with osteoporosis — much more so than was originally believed," said Harinder Singh, MD, who led the study, told Medscape Diabetes & Endocrinology.

The research method was a retrospective chart review at an outpatient endocrinology clinic in Las Vegas, Nevada. The inclusion criteria were osteoporosis diagnosed on DEXA scan and documented vitamin D levels, irrespective of race, sex, age, or other underlying diagnoses.

Donald Bergman, MD, clinical professor of medicine at Mount Sinai Medical Center in New York and a past president of the American Association of Clinical Endocrinologists, pointed out that both young and old are lacking in vitamin D.

"A lot of kids are also vitamin D deficient," said Dr. Bergman, who was not involved in the study.

Vitamin D is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling. Sufficient vitamin D prevents rickets in children and osteomalacia in adults and, together with calcium, vitamin D helps protect older adults from osteoporosis.

In Dr. Singh's study, researchers reviewed 328 charts with a diagnosis of osteoporosis. The 71 that had documented 25-hydroxyvitamin D levels were included in the study. Patients were taking vitamin D 800 IU and calcium 1200 mg daily; 25-hydroxyvitamin D level was checked during this peroid.

Researchers also reviewed other risk factors, including family history of osteoporosis, tobacco use, steroid use, and major preexisting medical diagnoses.

The average age of the patients was 62.2 years, and 89% were females. A total of 60 patients (84.5%) were white, 11 (15.5%) were smokers, 5 (7%) had family history of osteoporosis, 2 (2.81%) had a history of at least 1 osteoporotic fracture, 13 (18.3%) were taking steroids for various medical reasons, 13 (18.3%) were found to be vitamin D deficient (<20 ng/mL), 16 (22.5%) were vitamin D insufficient (20–30 ng/mL), and 7 (9.86%) were hypocalcemic (<9 mg/dL).

Singh called the findings "alarming" and said that although many physicians believe vitamin D deficiency is not a problem, with 41% of study patients found to have a vitamin D level of less than 30 ng/mL, "most likely that is not true," he said.

The study was independently funded. The authors have disclosed no relevant financial relationships.

American Association of Clinical Endocrinologists 17th Annual Meeting and Clinical Congress: Abstract 520. Presented May 16, 2008.


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