Do Low Vitamin D Levels Correlate With Osteoporosis?

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

Osteopenia and Osteoporosis in a Hypertensive Population

Presented at  CSANZ  Annual  Scientific  Meeting, Perth, Australia, 11-14  August  2011

Neil K. Agarwal,  Shashi K. Agarwal, MD

Introduction:  Hypertension is a common risk factor for coronary artery disease and stroke, two serious causes of cardiovascular morbidity and mortality. Osteoporosis related hip fractures result in pain, disability, diminished quality of life and increased mortality rates in men and women. The presence of osteoporosis in a hypertensive population may therefore prognosticate a worse clinical course. This study was undertaken to assess the prevalence of osteopenia and osteoporosis in hypertensive patients.

Methods: We reviewed dual-emission X-ray absorptiometry (DXA) scans of 220 consecutive hypertensive patients. Bone mineral density (BMD) was measured at the hip and spine. T scores were considered normal between +1 and -1. T scores were classified as osteopenia between -1 and -2.5 and osteoporosis if lower than -2.5.

Results: Of the 220 patients (ages: 20 – 87 years) [123 (55.9%) males; 97 (44.1%) females], 102 (46.4%) [67 (65.7%) males; 35 (34.3%) females] had normal T scores. 118 (53.6%) [56 (47.5%) males; 62 (52.5%) females] had abnormal T scores. Of these, 75 (63.6%) [35 (46.7%) males; 40 (53.3%) females] had T scores consistent with osteopenia and 43 (36.4%) [20 (46.5%) males; 23 (53.5%) females] had T scores consistent with osteoporosis.

Conclusion: Osteopenia and osteoporosis are common in hypertensive patients. T scores consistent with osteopenia were found in approximately 34% and those consistent with osteoporosis were found in approximately 20% of our hypertensive population. Hypertensive treatment combined with strategies to prevent and treat osteoporosis may improve the clinical course of these patients.