Background/Purpose: Vitamin D is implicated in bone homeostasis and its deficiency is associated with a progressive bone loss and fragility fractures. Our aim was to characterize vitamin D levels in Portuguese post-menopausal woman and evaluate its association with prevalent osteoporotic vertebral fractures (VF) and vertebral bone mineral density (BMD). 

Methods: The present study was conducted under the scope of EpiReumaPt cross-sectional, population-based study. The study population was women ≥ 65years-old from EpiReumaPt (882 participants representative of Portuguese postmenopausal women). 25- hydroxyvitamin D serum levels were determined and Vitamin D insufficiency was defined as <30ng/ml and Vitamin D deficiency as <10ng/ml. Clinical Risk factors for fractures and OP treatment were assessed. Ten-year risk of fractures was calculated using FRAX tool. VF were evaluated by CT Scan and classified using the Genant method. Vertebral BMD was performed and osteoporosis was defined using the t-score cut-offs of the World Health Organization. Prevalence estimates were computed as weighted proportions for take into account the sampling design. Multivariate regression models were used to assess the association of vitamin D levels and VF and BMD. Age, body mass index, NUTS II, seasons and glomerular filtration rate were considered as possible confounders.

Results:  Vitamin D insufficiency was present in 38.4% of Portuguese postmenopausal women and 14.2% had vitamin D deficiency. The prevalence of osteoporosis was 15% and of VF was 11.7% among Portuguese postmenopausal women. Regarding clinical risk factors 49.1% of postmenopausal women reported having at least one previous fragility fracture independently of the localization. The mean10-year risk for a major fracture was 9.9 ± 9.5 % and for hip fracture was 4.4 ± 7.2%. A significant number of postmenopausal women had ≥10% of 10- year risk for major fracture (38.2 %) and of postmenopausal women had ≥3 % of 10-year risk for hip fracture (7.9 %). Only, 53% of the OP postmenopausal women were under treatment. Vitamin D deficiency was independently associated with prevalent VF (OR=15.9; 95%CI 1.93,130.55; p= 0.010) but not with vertebral BMD (β= -0.016; 95%IC -0.178, 0.146; p=0.848). Vitamin D insufficiency was not significantly associated with VF or with BMD.

Conclusion:  Portugal is a sunny country of Southern Europe, levels of vitamin D are below the recommended levels for a large proportion of post-menopausal Portuguese women and this fact is associated with vertebral fragility fractures. Vitamin D supplementation recommendations should be reviewed and public health policies should address this issue.

« Back to ACR/ARHP Annual Meeting 2016

ACR Meeting Abstracts - https://acrabstracts.org/abstract/vitamin-d-levels-and-fragility-fractures-in-postmenopausal-portuguese-women-results-from-epireumapt/