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Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2004-2364
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The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 6 3215-3224
Copyright © 2005 by The Endocrine Society

Prevalence of Vitamin D Inadequacy among Postmenopausal North American Women Receiving Osteoporosis Therapy

Michael F. Holick, Ethel S. Siris, Neil Binkley, Mary K. Beard, Aliya Khan, Jennifer T. Katzer, Richard A. Petruschke, Erluo Chen and Anne E. de Papp

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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