Are serum calcium and vitamin D levels effective in osteoporosis?

Öz

Objective: Compare serum calcium and vitamin D levels of osteoporotic and non-osteoporotic patients. Material and method: The study included a total of 181 non-osteoporotic individuals and 94 osteoporotic patients over 50 years of age, post-menopausal, who referred to the gynecological clinic at our hospital and diagnosed with osteoporosis following a Dual Energy X-Ray Absorptiometry (DEXA) after their serum calcium and vitamin D levels were checked by laboratory analyses. Both groups were comprised of patients who did not receive any medication due to a chronic disease or osteoporosis. Descriptive statistics and graphs, as well as statistical analysis (Chi-Square Test, Independent Samples T-Test, One-Way ANOVA Test and Pearson's Correlation) were used in the study. These analyses were calculated at a 95% confidence level. SPSS 19.0 (Statistical Package for the Social Science) was used for analysis and calculation of descriptive statistics. Results: Both groups were compared individually in terms of age, body mass index (BMI), gravida, parity, abortion, curettage, age of menarche, age of menopause, duration of menopause, smoking and alcohol consumption, total lumbar T score, femoral neck T score, serum calcium and vitamin D. Demographic data and clinical features were statistically similar in both groups; however, total lumbar T score and femoral neck T score were significantly lower in the osteoporotic group. There was no significant association between age and osteoporosis. (χ²=3.381, p=0.184). There was no significant difference in vitamin D levels between age groups (F=0.552, p=0.576). The peer groups presented no significant difference in terms of calcium levels (F=0.716, p=0.490). There was no significant difference in vitamin D levels between osteoporotic and non-osteoporotic groups as well (t=-0.83, p=0.934). The groups showed no significant difference in terms of calcium levels (t=0.587, p=0.564). No association was detected between the measured vitamin D and calcium levels (Pearson's Correlation: 0.049, p=0.416). Conclusion: We can use serum calcium and vitamin D levels together with other methods that provide information about whether patients have osteoporosis. In light of this information, we can begin prophylaxis or early treatment of osteoporosis, which is currently a common disease that leads to morbidity and mortality.

Anahtar Kelimeler

• osteoporosis
• menopause
• calcium
• vitamin D

Kaynakça

1. Boonen S, Nijs J, Borghs H, Peeters H, Vanderschueren D (2005). Identifying postmenopausal women with osteoporosis by calacaneal ultrasound, metacarpal digital X-ray radiogrammetry and phalangeal radiographicabsorptiometry: a comparative study. Osteoporos Int;16,93-100.
2. Chapuy, M.C., Arlot, M.E., Duboeuf. F., Brun, J., Crouzet, B-, Arnaud, S., Delmas, P.D., and Meunier, P J (1992). Vitamin D3 and calcium to prevent hip fractures in the elderly women. New England Journal of Medicine, 32(T). 1637-42.
3. Chen YT, Miller PD, Barrett-Connor E, Weiss TW, Sajjan SG, Siris ES (2007). An approach for identifying postmenopausal women age 50-64 years at increased short-term risk for osteoporotic fracture. Osteoporos Int, 18, 1287-96.
4. Fordham JN (2004) Use of bone densitometry and other techniques in the diagnosis and management of osteoporosis. In: Osteoporosis. Your Questions Answered, Churchill Lvingstone, China, 79-98.
5. Gallagher JC. (2007). Effect of early menopause on bone mineral density and fractures. Menopause,14, 567-71.
6. Gulseren P , Ruhusen K, Selma C. (2014). Evaluation of Quality of Life in Postmenopausal Women with and without Osteoporosis using the QUALEFFO-41 Scale. Turk J Phys Med Rehab, 60, 139-46.
7. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 96, 1911-30
8. Ledger, G.A., Burritt, M.F., Kao, P.C., O'Fallon, W .M., Riggs, B.L., and Khosla, S. (1994). Abnormalities of parathyroid hormone secretion in elderly women that are reversible by short term therapy with 1,25-dihydroxyvitamin D3. Journal of Clinical Endocrinology and Metabolism, 79, 211-6.

9. Lips P. (2001). Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev, 22, 477-501
10. Lips, P., van Ginkel, F.C., Jongen, M.J., Rubertus, F., van der Vijgh, W.J., and Netelenbos, J.C. (1987). Determinants of vitamin D status in patients with hip fracture and in elderly control subjects American Journal of Clinical Nutrition, 46, 1005- 10.
11. Lips P, van Schoor NM. (2005). Quality of life in patients with osteoporosis. Osteoporos Int, 16, 447-55.
12. Lombardi IJr, Oliveria LM, Monteiro CR, Confessor YQ, Barros TL, Natour J. (2004). Evaluation of physical capacity and quality of life in osteoporotic women. Osteoporos Int, 15, 80-5.
13. Lukert B, Higgins J, Stoskopf M. (1992). Menopausal bone loss is partially regulated by dietary intake of vitamin D. Calcif Tissue Int; 51:173-9.
14. Martinez, M.E., del Campo, M.T., Sanchez-Cabezudo, M.J., Garcia, J.A., Sanchez Calvin, M.T., Torrijos, A., Coya, J., and Munuera, L. (1994). Relations between calcidiol serum levels and bone mineral density in postmenopausal women with low bone density Calcified Tissue International, 55, 253-6.
15. Pınar G, Pınar T, Nevin D, Azize K, Lale A, Aysel A, Esra K. (2009). Osteoporosis risk factors in the women over 45-years old. Dicle Med J, 36, 258-66.
16. Reginster JY (2005). The high prevalence of inadequate serum vitamin D levels and implications for bone health. Curr Med Res Opin, 21, 579-86.
17. Rodríguez-Martínez MA, García-Cohen EC (2002). Role of Ca(2+) and vitamin D in the prevention and treatment of osteoporosis. Pharmacol Ther, 93, 37-49
18. Schmitt NM, Schmitt J, Dören M (2009). The role of physical activity in the prevention of osteoporosis in postmenopausal women-An update. Maturitas, 63, 34-8.
19. Sernbo, I. and Johnell, O. (1993). Consequences of a hip fracture; a prospective study over 1 year. Osteoporosis International, 3, 148-53
20. Simonelli C, Adler RA, Blake GM, Caudill JP, Khan A, Leib E, Maricic M, Prior JC, Eis SR, Rosen C, Kendler DL (2008). Dual-Energy X-Ray Absorptiometry Technical issues: the 2007 ISCD Official Positions. J Clin Densitom, 11, 109-22.
21. Sosa Henríquez M, Gómez de Tejada Romero MJ (2009), Evidenced based medicine and drugs approved for the treatment of osteoporosis. Role of calcium and vitamin D. Rev Clin Esp, 209, 25-36.
22. Wardlaw GM (1996). Putting body weight and osteoporosis into perspective. Am J Clin Nutr. 63(3),433-436. doi: 10.1093/ajcn/63.3.433. PMID: 8615336.