Prevalence of Vitamin D Deficiency, Insufficiency and Secondary Hyperparathyroidism in Brazilian Postmenopausal Women with Osteoporosis

Presentation Number: MON 324
Date of Presentation: April 3rd, 2017

Sylvia Asaka Yamashita Hayashida*1, Edson Santos Ferreira Filho2, Jose Maria Soares Jr3, Ricardo Santos Simões4, Gustavo A R Maciel5, Isabel Cristina Esposito Sorpreso4 and Edmund Chada Baracat4
1Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRAZIL, 2Hospital das Clínicas, Faculdade de Medicina da USP, São Paulo, Brazil, 3Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil, 4Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 5Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil


Osteoporosis is a generalized skeletal disease characterized by compromised bone mass that predisposes to an increased risk of fractures. The vitamin D deficiency and secondary hyperparathyroidism may contribute to bone fragility. OBJECTIVE: The aim of the study was to evaluate the profile of postmenopausal patients with osteoporosis in the Gynecological Clinic of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo and identify the frequency of secondary hyperparathyroidism due vitamin D deficiency. METHODS: cross-sectional study of frequency, which were included patients from June 2008 to April 2016. The variables analyzed were: age at diagnosis of osteoporosis, menopausal age, body mass index, race, family history of osteoporosis, personal fracture history, hormone therapy use, calcium intake in the diet, smoking, sun exposure, physical activity, bone mineral density in lumbar spine and femoral neck, serum 25-hydroxy-vitamin D, serum and urinary calcium levels and parathyroid hormone (PTH). Statistical analysis was performed using the Graph Pad Prism 5.0 program. RESULTS: From a total of 462 patients initially recruited, 308 were selected for analysis. The average age at diagnosis of osteoporosis was 63.4 ± 7.3 years with menopause at 48.4 ± 4.4 years. Most patients were overweight (70%), Caucasian, with no family history of osteoporosis and fracture. The frequency of secondary hyperparathyroidism was almost 48% when the levels of vitamin D were less 20 ng/mL. However, the vitamin D levels less than 30 ng/mL identified 39.4% of secondary hyperparathyroidism. CONCLUSION: The secondary hyperparathyroidism are frequent in patients with postmenopausal osteoporosis, especially with vitamin D deficiency, even though insufficiency. The impact of secondary hyperparathyroidism with vitamin D deficiency on bone mass and osteoporosis rate of progression may suggest the need for screening and therapeutic intervention more emphatically in this group of patients.


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