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

Vitamin D: An Important Supplement to Prevent Cardiovascular Diseases in African-American Patients with Hypertension

Neil K Agarwal , Rutgers Univ, New Brunswick, NJ; Shashi K Agarwal, MD, FACC, Agarwal Health Ctr, East Orange, NJ

Presented at Preventive Medicine 2011, San Antonio, Texas, February 16-19, 2011

Purpose: African-Americans suffer from high rates of hypertension (HTN), a major risk factor for cardiovascular disease (CVD). African-Americans are also at a higher risk of developing vitamin D deficiency due to their increased skin pigmentation. A strong correlation exists between vitamin D deficiency and CVD. This study was done to assess the presence of vitamin D deficiency in African-American patients with HTN.

Methods: A retrospective review of charts and reports of consecutive blood tests done on African-American hypertensive patients over an eight month period was done. Vitamin D was measured as 25-hydroxyvitamin D in the blood and reported as ng/ml. The levels were classified as follows: 30 ng/ml or above: normal; 20 to 29 ng/ml: mild deficiency; 10 to 19 ng/mL: moderate deficiency; 9 ng/ml or less: severe deficiency

Results: 214 African American patients had their blood drawn during the study period. Of these, 108 (50.5%) were males and 106 (49.5%) were females. Their ages ranged from 21 to 91 years. Of the total, 183 (85.5%) had low levels of 25-hydroxyvitamin D and 31 (14.5%) had normal levels. Of the patients with low levels, 15 (8.2%) had severe deficiency [9 (60.0%) males and 6 (40.0%) females], 122 (66.7%) had moderate deficiency [58 (47.5%) males and 64 (52.5%) females], and 46 (25.1%) had mild deficiency [22 (47.8%) males and 24 (52.2%) females].

Conclusion: An extremely high percentage (85.5%) of African-American patients with HTN suffers from vitamin D deficiency. The majority of these patients (74.9%) suffer from moderate to severe deficiency.

Public Health Implication: African-Americans with HTN should be routinely tested for vitamin D deficiency. Further, as most of these patients have moderate or severe deficiency, they may need much higher doses of vitamin D supplementation, than those generally recommended.

Data Source Utilized: Patient charts and lab reports in a Cardiologists Office.