title: Vitamin d deficiency in postmenopausal women - biological correlates.
abstract: BACKGROUND
  Low vitamin D (VD) is associated with secondary hyperparathyroidism and both contribute to deleterious consequences (reduced bone mineral density (BMD), risk of fractures and falls).
  
  
  OBJECTIVE
  To study the VD status and biological correlates in a group of postmenopausal women.
  
  
  METHODS
  We studied 123 postmenopausal women evaluated in the C.I.Parhon National Institute of Endocrinology, the Pituitary and Neuroendocrine Diseases department. All cases had been reffered for the evaluation of BMD by the general practitioner. The evaluation included serum measurements of total and ionised calcium, phosphorus, alkaline phosphatase (ALP), 25 hydroxi vitaminD (25OHD), parathyroid hormone (PTH), osteocalcin, betacrosslaps. Central DXA osteodensitometry was performed.
  
  
  RESULTS
  91.9% of cases had 25OHD serum levels below 30 ng/ml (74.8% had VD deficiency, 17.1% VD insufficiency). Only 8.1% had sufficient VD levels. A history of fragility fractures was present in 45.83% of the osteoporotic patients, 27.27% of the osteopenic ones and 15.15% of the women with normal BMD. 32 women (26%) were on VD supplementation at the time of evaluation. Among these subjects, the 25OHD level was significantly higher in those with prior fragility fractures (p=0.018) and osteoporosis (p=0.008). 25OHD concentration negatively correlated with PTH, alkaline phosphatase (ALP) and osteocalcin. The bone markers evaluated had a significant inverse correlation with the radius BMD, T and Z scores (p=0.004). 27.17% of the cases with VD deficiency had secondary hyperparathyroidism. The 25OHD concentration was significantly lower in these cases (p=0.000).
  
  
  CONCLUSIONS
  VD insufficiency is widely prevalent but still under-recognized and under-treated, possibly leading to secondary hyperparathyroidism. The compliance to VD supplementation is lower in subjects without osteoporosis or fragility fractures. Primary prevention measures should be more actively implemented.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "C.I.Parhon" National Institute of Endocrinology and Metabolism, Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Capatina
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "C.I.Parhon" National Institute of Endocrinology and Metabolism, Bucharest, Romania.
authors.forename: Mara
authors.initials: M
authors.lastname: Carsote
authors.affiliation: "C.I.Parhon" National Institute of Endocrinology and Metabolism, Bucharest, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Caragheorgheopol
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "C.I.Parhon" National Institute of Endocrinology and Metabolism, Bucharest, Romania.
authors.forename: Catalina
authors.initials: C
authors.lastname: Poiana
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Physical Medicine and Rehabilitation, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Berteanu
keywords: deficiency; postmenopausal; secondary hyperparathyroidism; vitamin D