title: Vitamin D Deficiency and Its Influence on Bone Metabolism and Density in a Brazilian Population of Healthy Men.
abstract: Vitamin D supplementation is universal for postmenopausal women, but not for elderly men, in whom osteoporosis is also commonly neglected. This study aimed to evaluate vitamin D deficiency and its association with secondary hyperparathyroidism, bone resorption, and bone density in Brazilian men. A total of 120 men, 20-93 years, were evaluated for serum calcium, phosphorus, creatinine, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone, biochemical markers of bone resorption (carboxy-terminal telopeptide, carboxy-terminal peptide of type I collagen), and bone mineral density (dual-energy X-ray absorptiometry). Glomerular filtration rate (GFR) below 30 mL/min/1.73 m2, chronic diseases, and medications affecting bone were the exclusion criteria. No participant reported previous low-impact fractures. In the overall population, 25(OH)D levels were below 30 ng/mL in 46.7%, and below 20 ng/mL in 27.6%. Among the 93 patients 50 years and older, 28 had osteoporosis. In those 70 years and older, the prevalence of vitamin D deficiency (42.1%), secondary hyperparathyroidism (46.4%), high bone resorption (39.6%), decreased GFR (39.2%), and osteoporosis (41.4%) was significantly higher than in the younger subjects (p < 0.005 for all comparisons). Serum parathyroid hormone increased with aging and declining GFR, but was not significantly associated with 25(OH)D or bone mineral density. There was a clear contribution of vitamin D deficiency to increased bone resorption and osteoporosis. Binary logistic regression model considering age, 25(OH)D, and bone resorption identified age ≥70 years as the main determinant of osteoporosis. Our data demonstrate a high prevalence of vitamin D deficiency in a male population living in Rio de Janeiro, and emphasize its participation on the pathogenesis of age-related bone loss. (Vitamin D deficiency and osteoporosis are common in elderly Brazilian men.).
authors.affiliation: Clementino Fraga Filho University Hospital-Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: marlyleite@gmail.com.
authors.forename: Marlianne Leite
authors.initials: ML
authors.lastname: Moreira
authors.affiliation: Clementino Fraga Filho University Hospital-Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Leonardo Vieira
authors.initials: LV
authors.lastname: Neto
authors.affiliation: Clementino Fraga Filho University Hospital-Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Madeira
authors.affiliation: Air Force Central Hospital, Rio de Janeiro, Brazil.
authors.forename: Renata Francioni
authors.initials: RF
authors.lastname: Lopes
authors.affiliation: Clementino Fraga Filho University Hospital-Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Maria Lucia Fleiuss
authors.initials: MLF
authors.lastname: Farias
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001862:Bone Resorption / Q000453:epidemiology*; D001842:Bone and Bones / Q000378:metabolism; D001938:Brazil / Q000453:epidemiology; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D064368:Healthy Volunteers; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C104450:25-hydroxyvitamin D; D003404:Creatinine; D002118:Calcium
keywords: Bone resorption; hyperparathyroidism; men; osteoporosis; vitamin D