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Department of Medicine, Section of Endocrinology (M.F.H.), Boston University Medical Center, Boston, Massachusetts 02118; Department of Medicine, Division of Endocrinology (E.S.S.), Columbia University, New York, New York 10032; Osteoporosis Clinical Research Program (N.B.), University of Wisconsin, Madison, Wisconsin 53705; Clinical Practice (M.K.B.), Utah Osteoporosis and Menopause Center, Salt Lake City, Utah 84111; Division of Endocrinology and Geriatrics, Department of Medicine (A.K.), McMaster University, Oakville, Ontario, Canada L6J 1X8; and Clinical Development (J.T.K., A.E.d.P.), Medical Communications (R.A.P.), and Biostatistics (E.C.), Merck & Co., Inc., West Point, Pennsylvania 19486
Address all correspondence and requests for reprints to: Michael F. Holick, M.D., Ph.D., Boston University School of Medicine, 715 Albany Street, M1013, Boston, Massachusetts 02118. E-mail: mfholick{at}bu.edu.
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.
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