Déficit de vitamina D en mujeres osteoporóticas postmenopáusicas con sobrepeso / obesidad

Abstract

Osteoporosis and obesity are two disorders of body composition, which are currently increasing in the population. Objective: To establish the prevalence of vitamin D (VD) deficiency in a population of osteoporotic postmenopausal women (MPM), with overweight (SP) and obesity (OB). Material and Methods: We evaluated 397 MPM, with a mean age of 65 (53-98) years, diagnosed with osteoporosis (OP) by bone mineral densitometry (BMD) with a GE Lunar Prodigy, by dual X-ray absorptiometry (DXA) in the city of Buenos Aires, metropolitan area (latitude 35° South) who attended to Centro TIEMPO between October and December 2009, for evaluation of bone mass. We excluded patients with thyroid, liver and kidney disease, and those receiving corticosteroids, anticonvulsants and anticoagulants. Body Mass Index (BMI) was classified as follows: <19 underweight (BP), between 19 and 25 normal weight (NP), between 25 and 30 SP, and greater than 30 OB. Serum 25OHD was measured by RIA using a Diasorin kit and results were stratified into <20, between 20 and 30, between 30 and 40, and >40 ng/ml. Statistical analysis was performed with Pearsons test, Chi-Square and Fishers exact test. Results: In this sample of MPM, BP was present in 2% (n=8), mean age 66 (54-80) years, NP in 37.8% (n=150), mean age 64 (53-79) years, SP 45.3% (n= 180), mean age 66 (55-98) years, and OB in 14.9% (n=59), mean age 67 (54-80) years. Values of 25OHD deficiency (<10 ng/ml) were not detected. In patients with OB, 44.8% (n=26) had 25OHD values <20, 41.4% (n=24) between 20 and 30, and 13.8% (n=8) between 30 and 40 ng/ml. The percentage of women having OP and OB, with 25OHD <20 ng/ml was higher compared with the overweight and normal weight group; the difference was statistically significant: Pearson Chi2 test p= 0.00048, and Fischer's exact test, p=0.0006. In the MPM group with SP, 23.9% (n=43) had values of 25OHD <20, 53.3% (n=96) between 20 and 30, 22.2% (n=40) between 30 and 40, and 0.6% (n=1) >40 ng/ml. In the group of patients with NP, 22.5% (n=34) had 25OHD values <20, 47.7% (n=72) between 20 and 30, 24.5% (n=37) between 30 and 40, and 5.3% (n=8) >40 ng/ml. Among MPM with BP, only in one (12.5%) the value was <20, 75.0% (n=6) had between 20 and 30, and 12.5% (n=1) between 20 and 30 ng/ml. Conclusion: Among postmenopausal women with osteoporosis, overweight/obesity and vitamin D deficiency are prevalent.