Do Low Vitamin D Levels Correlate With Osteoporosis?
Shashi Agarwal, MD, FACC, East Orange, NJ; Neil Argarwal, Edison, NJ

INTRODUCTION: Osteoporosis is related to many factors, including a
family history of the disease, tobacco use, steroid use, major preexisting
medical diseases and vitamin D deficiency. This retrospective study was
done to see if low vitamin D levels correlate with the presence of
osteoporosis.

METHODS: We reviewed the records of 101 consecutive
patients who had DXA scans and vitamin D levels done over the period
of one calendar year. Bone mineral density was measured at the hip and
spine by dual-energy X-ray absorptiometry. T scores were considered
normal between +1 and -1, osteopenia between -1 and -2.5 and
osteoporosis if lower than -2.5. Vitamin D was measured as serum 25-
hydroxy vitamin D by the DiaSorin ICMA method. Vitamin D levels were
categorized as: normal levels: 30ng/ml or higher; mild deficiency:
20ng/ml-29ng/ml; moderate deficiency: 10ng/ml-19ng/ml and severe
deficiency: 0ng/ml-9ng/ml.

RESULTS: Of the 101 patients (ages 20 to 88
years) [54 (53.5%) males; 47 (46.5%) females], 19 (18.8%) had normal
vitamin D levels and 82 (81.2%) had low levels. Of the 19 with normal
levels, 6 (31.6%) had normal DXA scan, 8 (42.1%) had osteopenia and 5
(26.3%) had osteoporosis. Of the 82 with low vitamin D levels, 39
(47.6%) had normal DXA scans, 32 (39.0%) had osteopenia and 11
(13.4%) had osteoporosis. Of the 28 with mild deficiency, 12 (42.9%)
were normal, 13 (46.4%) were osteopenic and 3 (10.7%) were
osteoporotic. Of the 50 with moderate deficiency, 27 (54.0%) were
normal, 17 (34.0%) were osteopenic and 6 (12.0%) were osteoporotic.
Of the 4 with severe deficiency, 0 (0.0%) were normal, 2 (50.0%) were
osteopenic and 2 (50.0%) were osteoporotic. The average age of those
who were normal was 52.59 years, those with osteopenia was 56.38
years, and those with osteoporosis was 57.91 years.

CONCLUSION: We
found that approximately one half of the patients with mild or moderate
vitamin D deficiency had evidence of either osteopenia or osteoporosis
on DXA scanning. All patients with severe deficiency were osteopenic or
osteoporotic. Osteoporotic patients tended to be older. However, there
was no diagnostic correlation between low vitamin D levels and the
presence of osteoporosis.

Presented at the Family Medicine Forum 2011, Montreal, November 2011