Relationship of hypovitaminosis D and secondary hyperparathyroidism with bone mineral density among UK resident Indo-Asians.
BACKGROUND
There is a high prevalence of vitamin D deficiency in UK resident Indo-Asians and this may be complicated by secondary hyperparathyroidism.


OBJECTIVE
To investigate the relationship between these conditions and bone mineral density (BMD) in Indo-Asian rheumatology patients.


METHODS
110 Indo-Asian patients presenting to a general rheumatology clinic were selected for the study, of whom 77 were vitamin D deficient (HD), and 33 also had associated secondary hyperparathyroidism (HD-SHPT). BMD measurements at the femoral neck (FN), lumbar spine (LS), distal radius (DR), and radius 33% were obtained. T and Z scores were used in the evaluation of the dual energy x ray absorptiometry findings. The Mann-Whitney U test and chi(2) tests were used in the statistical analysis.


RESULTS
The patients with HD-SHPT had significantly lower serum 25-OH-vitamin D, higher serum alkaline phosphatase, and lower calcium levels than the HD group. Both T and Z scores failed to show any significant difference between the groups in the LS, but patients with HD-SHPT compared with those with HD had significantly lower FN T scores (-1.05 (1.47) v 0.28 (1.22), p=0.003), FN Z scores (-0.45 (1.27) v 0.26 (0.96), p=0.001), DR T scores (-1.83 (1.82) v -0.44 (1.77), p<0.001), DR Z scores (-1.25 (1.44) v -0.08 (1.6), p=0.001), radius 33% T scores (-1.65 (1.66) v -0.79 (1.21), p=0.008), and radius 33% Z scores (-1.07 (1.28) v -0.44 (1.1), p=0.017).


CONCLUSIONS
Hypovitaminosis D complicated by secondary hyperparathyroidism is associated with significantly decreased bone mineral density.
Serhan
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E
Department of Rheumatology, New Cross Hospital, Wolverhampton WV10 0QP, UK Department of Clinical Chemistry, New Cross Hospital. e.serhan@btinternet.com
Holland
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MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D002118:Calcium / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007194:India / Q000208:ethnology; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000502:physiology; D018709:Statistics, Nonparametric; D006113:United Kingdom; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000503:physiopathology
D000469:Alkaline Phosphatase; D002118:Calcium