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High bone turnover in Muslim women with vitamin D deficiency
Terrence H Diamond1, Sherel Levy, Angelina Smith
1St George Hospital, University of New South Wales, Kogarah, NSW 2217, Australia. terrydiamond@optushome.com.au
Objective:
To measure bone turnover in Muslim women with vitamin D deficiency.
Design:
A cross-sectional study of a random sample of Muslim women aged 20-65 years, evaluated over a 6-month period from November 1999 to April 2000.
Setting And Participants:
146 women living in an urban community in south-western Sydney with adequate opportunities for sun exposure.
Main Outcome Measures:
Bone turnover as measured by urinary deoxypyridinoline (DPYD) excretion rates; and vitamin D status as determined by 25-hydroxyvitamin D (25OHD) levels, serum calcium levels and parathyroid hormone (PTH) concentrations.
Results:
We analysed data on 119 Muslim women (mean [SEM] age, 46.6 [1.1] years) who met the inclusion criteria. There were 81 (68.1%) women with serum 25OHD levels < 30 nmol/L (defined as "severe" vitamin D deficiency). Fifty-five (46.2%) women had evidence of high bone turnover (urinary DPYD excretion > 6.5 nmol/mmol creatinine). The women with "severe" vitamin D deficiency had significantly higher serum PTH levels (7.3 [0.3] v 5.4 [0.5] pmol/L; P = 0.001) and higher urinary DPYD excretion (7.2 [0.3] v 5.4 [0.2] nmol/mmol creatinine; P = 0.003) than women with serum 25OHD levels > or= 30 nmol/L. No significant differences were seen in their ages, menopausal status or serum calcium and phosphate measurements. The risk of developing high bone turnover was significantly greater in the women with "severe" vitamin D deficiency (relative risk = 5.52; 95% CI, 2-14.8; chi(2 )= 12.95; P = 0.0003).
Conclusion:
High bone turnover occurs in Muslim women with vitamin D deficiency.