Evaluation of role of vitamin-D levels in osteoporosis

Shambhu Prasad, Sharma B. P., . Saurabh


Background: Osteoporosis is a serious, worldwide, and growing health problem; WHO has estimated the 30% of all women, older than 50 years (post-menopausal) has osteoporosis. Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Bone strength reflects the integration of two main features: bone density and bone quality.

Methods: After clinical examination, patients were subjected to lab and radiological investigation as under: complete hemogram with ESR, serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25 (OH) vitamin-D, KFT, LFT, DEXA scan. From above data, vitamin-D levels DEXA scan (t-score) was collected and statistically analysed.

Results: 53 radiologically established cases by DEXA score (spine) of osteoporosis/osteopenia and 50 persons in control group of the age and sex match with normal DEXA score, presenting to OPD of central institute of orthopaedics, VMMC and Safdarjung Hospital were selected. The mean vitamin D3 level in cases was 19.37ng/ml with standard deviation of 10.2. Range of serum vitamin D3 levels in cases was from 7 to 51.2. Whereas mean vitamin D3 level in control group was 25.92 ng/ml with standard deviation of 7.24. Range of serum vitamin D3 levels in controls was from 10 to 35.5. The mean vitamin D levels of cases and control was 19.735±10.2 and 25.92±7.2 ng/ml respectively, these values were compared by using student t test and results were found to be statistically significant (P= 0.0001). The mean T score in spine cases was -2.59 with standard deviation of 0.92. Range of T score in cases was from -5.1 to -1. Whereas, mean T score in control group was -0.26 with standard deviation of 0.68. Range of T score in controls was from -0.9 to 1.4. The mean T score spine of cases and controls was -2.59±0.92 and -0.264±0.68 respectively, these values were compared by using student t test and results were found to be statistically significant (P = 0.0001).

Conclusions: Study recommend that, vitamin D supplementation should be given to patients with osteopenia/osteoporosis. Further prospective studies to firmly establish the relationship between vitamin D and osteoporosis as well as evaluation of vitamin D supplementation in osteoporosis are needed.



DEXA, Osteoporosis, Post-menopausal, Vitamin D

Full Text:



Jones G, Nguyen T, Sambrook PN. Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study. Osteopo Internat. 1994;4(5):277-82.

World Health Organization. International Classification of Functioning, Disability and Health. World Health Organization: Geneva; 2001.

Diamond T, Lindenburg M. Osteoporosis detection in the community. Are patients adequately managed? Australian Family Physician. 2002;31:751-2.

Lukert B, Higgins J, Stoskopf M. Menopausal bone loss is partially regulated by dietary intake of vitamin D. Calcif tissue Int. 1992;51:173-9.

Villareal DT, Civitelli R, Chines A, AvioliLV. Subclinical vitamin D deficiency in post-menopausal women with low vertebral bone mass. J Clin Endocrinol Metab. 1991;72(3):628-34.

Khaw KT, Sneyd MJ, Compston J. Parathyroid hormone and 25-hydroxyvitamin Dconcentration in middle aged women. BMJ. 1992;305:273-7.

Kanis JA, Melton LJ, Christiansen C. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9:1137-41.

Agarwal RP, Hindonia M, Kochar A, Kochar DK. Evaluation of bone mineral density by osteosonography in patients with type 2 diabetes mellitus. J Indian Acad Clin Med. 2005;6(20):119-35.

Paul TV, Thomas N, Seshadri MS ,Oommen R, Jose A, Mahendri NV . Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin d status. Endocr Pract. 2008;14(6):665-671.

Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, et al. A global study of vitamin d status and parathyroid function in post-menopausal women with osteoporosis: baseline data from the multiple outcome of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86(3)1212-21.

Trang HM, Cole DE, Rubin LA, Pierratos A, Siu S, Vieth R. Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. J Clin Nutr. 1998;68(4):854-8.

Holick MF, Biancuzzo RM, Chen TC. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2008;93(3):677-81.

Ooms ME, Lips P, Roos JC, Vandervigh WJ, Popp-Snijders C, Bezemer PD, et al. Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res. 1995;10:1177-84.

Nakamura K, Tsugawa N, Saito T, Ishikawa M, Tsuchiya Y, Hyodo K, et al. Vitamin D status, bone mass and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi study. Bone. 2008;42:271-7.

Roy DK, Berry JL, Pye SR, Adams JE, Swarbrik CM, King Y, et al. Vitamin D status and bone mass in UK South Asian women. Bone. 2007;40:200-4.

Walts NB. T-score and Osteoporosis. Menopause Med. 2002;10:1-4.