Hypovitaminosis D and prevalent asymptomatic vertebral fractures in Moroccan postmenopausal women

Abdellah El Maghraoui,Ahmed Bezza,Saida Tellal,Asmaa Rezqi,Aziza Mounach,Mohamed Dehhaoui,Zhor Ouzzif,Imad Ghozlani,Lahsen Achemlal

doi:10.1186/1472-6874-12-11

Abstract

BackgroundHypovitaminosis D is associated to accentuated bone loss. However, association between osteoporotic vertebral fractures (VFs) and vitamin D status has not been clearly established.ObjectiveTo determine serum vitamin D status and to assess the association of vitamin D status with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women.Methodsfrom June to September 2010, 178 menopausal women 50 years old and over were enrolled in this cross-sectional study. The mean ± SD (range) age, weight, height and BMI were 58.8 ± 8.2 (50 to 79) years, 73.2 ± 13.8 (35 to 119) Kgs, 1.56 ± 0.06 (1.43 – 1.79) m and 29.8 ± 5.9 (17.5 – 49.8) kg/m2, respectively. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured.ResultsAmong the 178 women, 45 (25.2%) had densitometric osteoporosis, and on VFA, VFs (grade 2 or 3) were detected in 20.2% while grade 1 were identified in 33.1%. The mean values of serum levels of 25(OH)D were 15.8 ± 11.6 ng/ml (range: 3.0 – 49.1) with 152 patients (85.3%) having levels <30 ng/ml (insufficiency) and 92 (51.6%) <10 ng/ml (deficiency). Stepwise regression analysis showed that presence of VFs was independently related to age, 25(OH)D and densitometric osteoporosis.Conclusionour study shows that advanced age, hypovitaminosis D and osteoporosis are independent risk factors for asymptomatic VFs in Moroccan postmenopausal women.

Highlights

Hypovitaminosis D is associated to accentuated bone loss
Conclusion: our study shows that advanced age, hypovitaminosis D and osteoporosis are independent risk factors for asymptomatic vertebral fractures (VFs) in Moroccan postmenopausal women
The prevalence of osteoporosis was 25.2% (n = 45). In these 178 women, 74% of vertebrae from T4–L4 and 82% from T8–L4 were adequately visualized on vertebral fracture assessment (VFA)

Summary

Introduction

Hypovitaminosis D is associated to accentuated bone loss. Association between osteoporotic vertebral fractures (VFs) and vitamin D status has not been clearly established. Vitamin D status has for long been recognized as an important factor for bone health and its contribution to fracture risk has recently received increased attention. It is demonstrated that hypovitaminosis D is associated to accentuated bone. Direct sunlight stimulates the production of vitamin D in the skin from 7-dehydrocholesterol. The duration of UVB irradiation needed to produce a certain quantity of vitamin D in a particular skin surface depends on season, time of day, and geographical location. The higher the latitude, the lower the UVB intensity, and the fewer months and hours per day during which vitamin D is produced

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