Prevalence of Vitamin D Inadequacy among Postmenopausal North American Women Receiving Osteoporosis Therapy

TLDR

The study assessed serum 25‑hydroxyvitamin D levels and determinants of vitamin D inadequacy in postmenopausal North American women undergoing osteoporosis therapy. Serum 25‑hydroxyvitamin D and parathyroid hormone were measured in 1,536 community‑dwelling women (Nov 2003–Mar 2004), and multivariate logistic regression identified risk factors for suboptimal 25‑hydroxyvitamin D (<30 ng/mL). More than half of participants had suboptimal vitamin D (<30 ng/mL), with 18% <20 ng/mL and 36% <25 ng/mL; inadequacy was higher among those taking <400 IU/day, correlated negatively with PTH, and associated with age, race, BMI, medication use, supplementation, exercise, education, and physician counseling, underscoring the need for better education on vitamin D optimization.

Abstract

Purpose: To evaluate serum 25-hydroxyvitamin D [25(OH)D] concentrations and factors related to vitamin D inadequacy in postmenopausal North American women receiving therapy to treat or prevent osteoporosis. Methods: Serum 25(OH)D and PTH were obtained in 1536 community-dwelling women between November 2003 and March 2004. Multivariate logistic regression was used to assess risk factors for suboptimal (<30 ng/ml) 25(OH)D. Results: Ninety-two percent of study subjects were Caucasian, with a mean age of 71 yr. Thirty-five percent resided at or above latitude 42° north, and 24% resided less than 35° north. Mean (sd) serum 25(OH)D was 30.4 (13.2) ng/ml: serum 25(OH)D was less than 20 ng/ml in 18%; less than 25 ng/ml in 36%; and less than 30 ng/ml in 52%. Prevalence of suboptimal 25(OH)D was significantly higher in subjects who took less than 400 vs. 400 IU/d or more vitamin D. There was a significant negative correlation between serum PTH concentrations and 25(OH)D. Risk factors related to vitamin D inadequacy included age, race, body mass index, medications known to affect vitamin D metabolism, vitamin D supplementation, exercise, education, and physician counseling regarding vitamin D. Conclusions: More than half of North American women receiving therapy to treat or prevent osteoporosis have vitamin D inadequacy, underscoring the need for improved physician and public education regarding optimization of vitamin D status in this population.