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Abstract Number: 2328

Current Factors Associated with Insufficient Vitamin D Status in Patients with Osteoporosis

Sandeep Dhillon1, Arzoo Alam2, Matthew Wong-Pack3, Arthur Lau4, Karen A. Beattie5 and Jonathan D. Adachi6,7, 1Department of Medicine, McMaster University, Hamilton, ON, Canada, 2McMaster University, Hamilton, ON, Canada, 3University of Toronto, Toronto, ON, Canada, 450 Charlton Avenue East, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada, 5Medicine, McMaster University, Hamilton, ON, Canada, 6Division of Rheumatology, McMaster University, Hamilton, ON, Canada, 7St Joseph's Healthcare Hamilton, Hamilton, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: 25 OH D Vitamin insufficiency, 25-hydroxyvitamin D, Vitamin D and osteoporosis

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Session Information

Date: Tuesday, October 23, 2018

Session Title: Osteoporosis and Metabolic Bone Disease – Basic and Clinical Science Poster

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: In 2010, the Canadian Osteoporosis guidelines recommended that patients with osteoporosis be supplemented with vitamin D and to achieve serum levels ≥75nmol/L. Past studies, most of which were completed before these guidelines could be implemented, showed that there is a large proportion of patients whose levels are below this target. For this reason, we aimed to assess the current uptake of these guidelines in osteoporosis patients by: 1) Determining the current prevalence of patients who are vitamin D-sufficient (≥75nmol/L); 2) Assessing factors associated with vitamin D insufficiency; and 3) Identifying groups of patients who are not on vitamin D supplementation.

Methods: We retrospectively reviewed charts of patients referred to a single osteoporosis clinic in Hamilton, Canada, seen between April and October 2017. Inclusion criteria were a lumbar spine or femoral neck T-score ≤-2.5 or a major fragility fracture, and age above 18 years. Data from the initial consultation appointment was extracted. We also collected absolute vitamin D levels and determined vitamin D insufficiency (<75nmol/L) as well as its prevalence. Further, we determined the effects of age, sex, vitamin D intake, BMI, eGFR, fracture history, and PPI use on vitamin D sufficiency and supplementation rates and investigated their role on PTH, calcium levels, fracture prevalence, and BMD. Where appropriate, we completed a Pearson’s chi-squared analysis or a Pearson correlation analysis.

Results: Charts were reviewed from 180 patients, mean age 65.8 years (SD 11.9) 78.3% (141/180) female, 82.2% (148/180) reported taking vitamin D supplements. The average vitamin D level was 93.7nmol/L (SD 34.1) and 75% (135/180) were vitamin D-sufficient. We found that patients with vitamin D insufficiency were significantly older (69.2 vs 64.6 years, r=0.169, p=0.023) with no effect on other bone parameters. We also found that vitamin D-insufficient patients had a significantly lower eGFR (69.6 vs 78.3mmol/L, r=0.210, P=0.005), which was inversely correlated with PTH level (r=-0.229, p=0.002). Lastly, we found a difference in sex and vitamin D supplementation rates, as males were less likely to be on vitamin D supplementation (57.9% vs. 91.3%, X2=24.86, p<0.001). Other bone parameters were not significantly affected.

Conclusion: In our retrospective analysis, we found that currently, there is strong adherence to the Canadian guidelines for vitamin D status in patients with osteoporosis in Hamilton, Ontario. However, we identified that there continues be a care gap for patients who are older, male, or have a lower eGFR with regards to their vitamin D status, which are factors that we recommend for practitioners to follow more closely.


Disclosure: S. Dhillon, None; A. Alam, None; M. Wong-Pack, None; A. Lau, AbbVie Inc., 8, 9,Amgen Inc., 8, 9,BMS, 8, 9,Celgene Corporation, 8, 9,Eli Lilly and Co., 8, 9,Merck & Co., 8, 9,Novartis, 8, 9,Janssen, 8, 9,Pfizer, Inc., 8, 9,Roche, 8, 9,Sanofi, 8, 9,Genzyme, 8, 9,UCB, Inc., 8, 9; K. A. Beattie, None; J. D. Adachi, Amgen Inc., 2, 5, 8,McMaster University, 3.

To cite this abstract in AMA style:

Dhillon S, Alam A, Wong-Pack M, Lau A, Beattie KA, Adachi JD. Current Factors Associated with Insufficient Vitamin D Status in Patients with Osteoporosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/current-factors-associated-with-insufficient-vitamin-d-status-in-patients-with-osteoporosis/. Accessed May 26, 2022.
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