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Spectacular improvement in vitamin D status in elderly osteoporotic women: 8-year analysis of an osteoporotic population treated in a dedicated fracture liaison service.
Osteoporos Int. 2015 Dec; 26(12):2869-75.OI

Abstract

In a population of postmenopausal women with a fragility fracture, we found a drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D, especially from 2009 onwards. These results show that supplementation has been very widely integrated into current practice.

INTRODUCTION

Vitamin D (25(OH)D) is essential for bone health. In institutionalised osteoporotic women, it reduces the risk of fragility fractures. Numerous articles suggesting the possibility of extraosseous effects have generated a growing number of publications and recommendations on more widespread administration, to limit the risks of moderate or severe hypovitaminosis D. We assessed the impact on clinical practice of these recommendations concerning 25(OH)D supplementation in elderly at-risk populations.

METHODS

A total of 1486 postmenopausal osteoporotic women were seen in the context of a fracture liaison service (i.e. a rheumatology consultation following a peripheral fragility fracture), between May 2005 and December 2012. Of these, 1107 had a 25(OH)D assay (femur, n = 520; humerus, n = 207; wrist, n = 380).

RESULTS

The average age of the total population was 76.7 ± 9.9 years, while for women with an available 25(OH)D assay, the average age was 75.1 ± 11.8 years. The average 25(OH)D (nmol/L) level was similar for the three fracture sites: femur, 30 ± 36.2; humerus, 27.5 ± 24; and wrist, 31 ± 26. A drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D was observed, especially from 2009 onwards, with a mean prevalence of 69 and 30 % respectively before that year and 35 and 52 % thereafter. Conversely, the proportion of women with 25(OH)D at the threshold value of 75 nmol/L increased from 1.2 to 24 %. Overall, mean serum 25(OH)D levels were significantly higher when comparing the two periods 2005-2008 and 2009-1012 (17.6 ± 14.6 and 48.4 ± 39.2 nmol/L, respectively; p < 0.0001).

CONCLUSION

These results show that supplementation has been very widely integrated into current practice. We can expect it to yield beneficial effects in osseous and extraosseous terms in osteoporotic women, particularly the very elderly.

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Publisher Full Text (DOI)

Authors+Show Affiliations

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France.

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France.

SSPIM, University Hospital of Saint-Etienne, Saint-Etienne, France. EA SNA-EPIS, PRES Lyon, Saint-Etienne, France.

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France.

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France.

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France.

INSERM U1059, Lab Biologie Intégrée du Tissu Osseux, Université de Lyon, Lyon, France. thierry.thomas@chu-st-etienne.fr. Rheumatology Department, University Hospital of Saint-Etienne, 42023, Saint-Etienne, France. thierry.thomas@chu-st-etienne.fr.

MeSH

AgedAged, 80 and overDietary SupplementsFemaleFemoral FracturesFranceHumansMiddle AgedOsteoporosis, PostmenopausalOsteoporotic FracturesPrevalenceProfessional PracticeVitamin DVitamin D Deficiency

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26104797

Citation

Amouzougan, A, et al. "Spectacular Improvement in Vitamin D Status in Elderly Osteoporotic Women: 8-year Analysis of an Osteoporotic Population Treated in a Dedicated Fracture Liaison Service." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 26, no. 12, 2015, pp. 2869-75.

Amouzougan A, Deygat A, Trombert B, et al. Spectacular improvement in vitamin D status in elderly osteoporotic women: 8-year analysis of an osteoporotic population treated in a dedicated fracture liaison service. Osteoporos Int. 2015;26(12):2869-75.

Amouzougan, A., Deygat, A., Trombert, B., Constant, E., Denarié, D., Marotte, H., & Thomas, T. (2015). Spectacular improvement in vitamin D status in elderly osteoporotic women: 8-year analysis of an osteoporotic population treated in a dedicated fracture liaison service. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 26(12), 2869-75. https://doi.org/10.1007/s00198-015-3206-y

Amouzougan A, et al. Spectacular Improvement in Vitamin D Status in Elderly Osteoporotic Women: 8-year Analysis of an Osteoporotic Population Treated in a Dedicated Fracture Liaison Service. Osteoporos Int. 2015;26(12):2869-75. PubMed PMID: 26104797.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Spectacular improvement in vitamin D status in elderly osteoporotic women: 8-year analysis of an osteoporotic population treated in a dedicated fracture liaison service. AU - Amouzougan,A, AU - Deygat,A, AU - Trombert,B, AU - Constant,E, AU - Denarié,D, AU - Marotte,H, AU - Thomas,T, Y1 - 2015/06/24/ PY - 2014/11/30/received PY - 2015/6/10/accepted PY - 2015/6/25/entrez PY - 2015/6/25/pubmed PY - 2016/9/16/medline KW - Fracture liaison service KW - Fragility fractures KW - Postmenopausal osteoporosis KW - Recommendations KW - Vitamin D SP - 2869 EP - 75 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 26 IS - 12 N2 - UNLABELLED: In a population of postmenopausal women with a fragility fracture, we found a drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D, especially from 2009 onwards. These results show that supplementation has been very widely integrated into current practice. INTRODUCTION: Vitamin D (25(OH)D) is essential for bone health. In institutionalised osteoporotic women, it reduces the risk of fragility fractures. Numerous articles suggesting the possibility of extraosseous effects have generated a growing number of publications and recommendations on more widespread administration, to limit the risks of moderate or severe hypovitaminosis D. We assessed the impact on clinical practice of these recommendations concerning 25(OH)D supplementation in elderly at-risk populations. METHODS: A total of 1486 postmenopausal osteoporotic women were seen in the context of a fracture liaison service (i.e. a rheumatology consultation following a peripheral fragility fracture), between May 2005 and December 2012. Of these, 1107 had a 25(OH)D assay (femur, n = 520; humerus, n = 207; wrist, n = 380). RESULTS: The average age of the total population was 76.7 ± 9.9 years, while for women with an available 25(OH)D assay, the average age was 75.1 ± 11.8 years. The average 25(OH)D (nmol/L) level was similar for the three fracture sites: femur, 30 ± 36.2; humerus, 27.5 ± 24; and wrist, 31 ± 26. A drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D was observed, especially from 2009 onwards, with a mean prevalence of 69 and 30 % respectively before that year and 35 and 52 % thereafter. Conversely, the proportion of women with 25(OH)D at the threshold value of 75 nmol/L increased from 1.2 to 24 %. Overall, mean serum 25(OH)D levels were significantly higher when comparing the two periods 2005-2008 and 2009-1012 (17.6 ± 14.6 and 48.4 ± 39.2 nmol/L, respectively; p < 0.0001). CONCLUSION: These results show that supplementation has been very widely integrated into current practice. We can expect it to yield beneficial effects in osseous and extraosseous terms in osteoporotic women, particularly the very elderly. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26104797/Spectacular_improvement_in_vitamin_D_status_in_elderly_osteoporotic_women:_8_year_analysis_of_an_osteoporotic_population_treated_in_a_dedicated_fracture_liaison_service_ DB - PRIME DP - Unbound Medicine ER -