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Abstract Title:

VITAMIN D DEFICIENCY IS ASSOCIATED WITH CORTICAL BONE LOSS AND FRACTURES IN THE ELDERLY.

Abstract Source:

Eur J Endocrinol. 2019 Aug 1. Epub 2019 Aug 1. PMID: 31484162

Abstract Author(s):

Francisco de Paula Paranhos Neto, Leonardo Vieira Neto, Miguel Madeira, Aline Moraes, Laura Maria Carvalho de Mendonça, Inaya Correa Barbosa Lima, Claudia Lopes Rodrigues Chagas, Daisy Anne Lira, Juliana Fernandes Spitz, João Antonio Matheus Guimarães, Maria Eugênia Leite Duarte, Maria Lucia Fleiuss Farias

Article Affiliation:

Francisco de Paula Paranhos Neto

Abstract:

INTRODUCTION: The role of vitamin D on bone microarchitecture and fragility is not clear.

OBJECTIVE: To investigate whether vitamin D deficiency (25(OH)D<20 ng/mL) increases cortical bone loss and the severity of fractures.

DESIGN: Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture.

METHODS: Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure.

RESULTS: Serum 25(OH)D levels were associated with body mass index (BMI: r= -0.161 p=0.006), PTH (r= -0.165 p=0.005), CTX (r=-0.119 p=0.043) and vBMD at cortical bone (Dcomp: r= 0.132 p=0.033) and entire bone (D100: r= 0.162 p=0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI 0.11 - 4.16; p<0.01), 25(OH)D (95% CI -0.007 - 1.70; p=0.05) and CTX (95% CI -149.04 - 21.80; p<0.01) predicted DComp, while BMI (95% CI 1.13 - 4.18; p<0.01) and 25(OH)D (95% CI 0.24 - 1.52; p<0.01) predicted D100. NonVFs predominated in patients with 25(OH)D<20 ng/mL (p=0.013). Logistic regression analysis showed a decrease in the likelihood of presenting grade 2-3 VFs / NonVFs for every increase in 25(OH)D (OR = 0.962, 95% CI 0.940 - 0.984; p=0.001), BMI (OR = 0.932, 95% CI 0.885 - 0.981; p=0.007) and D100 at radius (OR = 0.994, 95% CI 0.990 - 0.998; p=0.005).

CONCLUSION: In elderly patients with prevalent fractures, vitamin D deficiency was associated with cortical bone loss and severity of fractures.

Study Type : Human Study

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