scholarly journals Vitamin D deficiency as a factor in reducing bone mineral density after childbirth

2018 ◽  
Vol 67 (6) ◽  
pp. 60-68
Author(s):  
Tatyana V. Novikova ◽  
Irina E. Zazerskaya ◽  
Lyubov V. Kuznetsova ◽  
Viktor A. Bart
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Lumbar Spine ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Main Group ◽  
Reproductive Age ◽  
Distal Forearm ◽  
Mineral Density

Hypothesis/aims of study. Physiological pregnancy is not a reliable risk factor for reduced bone mineral density (BMD). The causes affecting BMD in reproductive age, such as smoking, heredity, low physical activity, low body mass index, unbalanced diet, ovarian dysfunction, and vitamin D deficiency are studied. The aim of this study was to assess the contribution of vitamin D deficiency and insufficiency to the development of osteopenia after childbirth. Study design, materials and methods. This is a cohort study conducted in V.A. Almazov National Medical Research Center, Saint Petersburg, Russia in the period from October 2013 to November 2014. We examined 86 puerperas on days 3–5 after delivery. The age of women ranged from 20 to 35 years. Patients were surveyed using the questionnaire on the main risk factors for osteoporosis. The method of dual energy X-ray absorptiometry was used to evaluate BMD in the central and peripheral skeleton. Serum levels of 25-hydroxycalciferol (25(OH)D) and parathyroid hormone were determined in all pregnant women. Results. According to the results of Х-ray osteodensitometry, normal BMD was detected in 45% (n = 38) of puerperas (comparison group), with reduced BMD revealed in 55% (n = 48) of puerperas (main group). The main group was divided into subgroups: osteopenia in the distal forearm was detected in 27 (56%) puerperas, in the proximal femur in 7 (16%) puerperas, and in the lumbar spine in 14 (28%) puerperas. 58-78% of patients showed vitamin D deficiency and insufficiency. In the group with osteopenia, vitamin D deficiency prevails, reaching 78% in women with osteopenia in the forearm, while in the group with normal BMD, vitamin D deficiency predominates in 70% of patients. The mean value of 25(OH)D in serum in the group with osteopenia and that in the group with normal BMD differ 1.5 times. The level of 25(OH)D in postpartum women with osteopenia in the forearm is two times lower, when compared to the group with normal BMD, parathyroid hormone being within reference values. In the group with osteopenia in the lumbar spine, opsooligomenorrhea is more common (p < 0.05), while in the group with osteopenia in the proximal forearm, a possible significant factor was revealed to be preeclampsia (p < 0.05). Conclusion. Osteopenia after childbirth is found in 55% of patients. In 56% of cases, osteopenia occurs in the distal forearm. Vitamin D deficiency is a significant factor in the reduction of BMD in the distal forearm and lumbar spine. At a level of 25 (OH) D < 20 ng/ml, the risk of developing osteopenia increases by 56%.

scholarly journals SAT-LB64 Teriparatide and Its Bone Healing Power

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Aneeta J Joseph ◽  
Jesus L Penabad ◽  
Antonio Pinero-Pilona
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Amino Terminal ◽  
Traumatic Fracture ◽  
C2 Fracture

Abstract Introduction: Teriparatide, a parathyroid hormone analog, is an important anabolic agent approved by the U.S. Food and Drug Administration to increase bone mineral density in osteoporotic patients. Parathyroid hormone (PTH) regulates calcium, phosphate, and active vitamin-D metabolites.The amino terminal peptide fragments of PTH has been known to increase bone mass and are being used in clinical practice for osteoporosis management (1). Current literature shows the efficacy of teriparatide in increasing bone density of lumbar spine and femoral neck, and decreasing the risk of vertebral and non-vertebral fractures both in postmenopausal women and men. It is also known to prevent fractures in patients with osteoporosis and promote healing of fractures (2). Case Description: A 79-year-old Hispanic female with history of osteopenia and major lumbar spine wedge compression fractures presented to our clinic for consultation. She was on ibandronate for the past four months and was having symptoms of pill esophagitis. Her last bone mineral density done on August 2017 revealed T-score of -2.5 at the lumbar spine, -1.5 at the left femoral neck, and 3.3% bone loss on the left femoral head. Rather than being started on teriparatide, zoledronic acid, or denosumab, she continued ibandronate along with calcium and vitamin D. Two months after the initial consultation, she sustained a traumatic fracture of the posterior arch and body of C2 bilaterally following a motor vehicle accident. There were discussions about starting anabolic treatment, as serial imaging did not show any significant improvement in the healing process despite the use of a collar. Two months after sustaining C2 fracture, she was started on teriparatide. Repeat cervical spine x-ray three months later showed complete healing of the C2 fracture. Discussion: There are a limited number of cases reported in regards to teriparatide induced healing of non-osteoporotic fractures (3). Our case is one of the very few reported to have shown complete radiographic and clinical healing of a traumatic, non-osteoporotic fracture after use of teriparatide for 12 weeks.

scholarly journals Factors influencing bone mineral density in postpartum women

2018 ◽  
Vol 21 (1) ◽  
pp. 10-16
Author(s):  
Tatiana V. Novikova ◽  
Lubov V. Kuznetsova ◽  
Natalia Yu. Yakovleva ◽  
Irina E. Zazerskaya
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Vitamin D Deficiency ◽  
Distal Radius ◽  
Bone Mineral ◽  
Calcium Intake ◽  
Z Score ◽  
Mineral Density ◽  
Group 1

Background: Osteopenia is a common condition. Therefore, identification of groups for prevention of osteoporosis and restoration of bone mineral density (BMD) remains relevant. Aim: to assess the factors contributing to development of osteopenia in puerperas. Methods: prospective cross-sectional study. We examined 112 patients aged 20-35, 3-5 days after delivery. To assess possible factors for BMD decrease, we analyzed medical history, lifestyle, nutrition, anthropometric data, obstetric and gynecological history, and pregnancy course. We also assessed serum levels of 25-hydroxycalciferol (25-OH-D) and PTH. BMD was measured by dual energy x-ray osteodensitometry. We considered Z-score from -1 to -2.5SD as osteopenia, below -2.5 SD-as osteoporosis. Results: based on Z-score values, two groups were formed: 1 (n=70) - puerperas with osteopenia, 2 (n=42) - puerperas with normal BMD. In the first group, osteopenia in the distal radius was observed in 48%, in the lumbar spine in 16% and in the proximal femur in 36%. Influence of the following possible factors in group 1 was established: BMI in 15-20 years ≤ 18 kg/m2 (p<0.013), BMI ≥ 25 kg/m2 (p<0.018), 25-OH-D less than 25 ng / ml (p < 0.0018), calcium intake less than 800 mg/day (p<0.041). Menstrual disorders (p<0.052) and preeclapsia (p < 0.042) affected lumbar spine BMD. In group 1, vitamin D deficiency was detected in 82% of women, 18% showed vitamin D insufficiency; in group 2, vitamin D deficiency was found in 16%, deficiency in 70%, in 14% vitamin D was normal. In women with a combination of factors such as BMI≤ 18 kg/m; calcium intake lower than 800 mg/day, menstrual cycle disorders, vitamin D deficiency - osteopenia in the distal radius occured 11 times more often (OR=11,47059; CI 95%=[4,0326; 32,627]). Conclusion: most significant impact on BMD decrease in puerperas can be expected if patient has the following risk factors: BMI≤18 kg/m2; 25-OH- D<25 ng/ml ; nutrition with calcium intake <800 mg per day, preeclampsia. Combination of these factors may increase the risk of osteopenia in the distal radius.

scholarly journals SERUM 25-HYDROXY VITAMIN D;

2017 ◽  
Vol 24 (03) ◽  
pp. 375-380
Author(s):  
Shazia Memon ◽  
Farzana Shiakh ◽  
Asadullah Makhdoom ◽  
S. M. Tahir
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Serum Vitamin ◽  
Mineral Density ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Low Serum

Deficiency of vitamin D is an emerging issue in children worldwide. It has beenobserved that all patients with vitamin D deficiency does not manifest clinical features or hyperparathyroidresponse. In this study we have evaluated the interaction of serum vitamin D level,parathyroid hormone (PTH) level and bone mineral density (BMD) in children. Objectives: Ourobjectives were to determine the frequency of Vitamin D deficiency in children and association oflow serum D level with serum parathyroid level and bone mineral density (BMD). Study Design:Descriptive cross sectional study. Period: June 2012 to May 2014. Setting: Pediatric and Orthopediatricout-patient departments. Material & Methods: A total of 500 children up to 15 yearswith low serum vitamin D level were enrolled to analyze the interaction of Serum vitamin D, PTHand BMD. Patients were divided in groups on the basis of serum PTH. We have categorize thedeficiency of Vitamin D on the basis of level of 25OHD. It was defined as severe (25OHD ≤ 5ng/ml), moderate (25OHD≤ 10 ng/ml) and mild (25OHD ≤ 20 ng/ml) and hyperparathyroidism(SHPT) was valued if level >65 pg/ml. All children with 25OH ≤ 20 ng/ml were included andassociation with SHPT and BMD were measured. Results: It has been observed that 30–40%of patients with moderate and severe deficiency of vitamin D respectively had shown increasedlevel of PTH. Bone mineral density has demonstrated decline pattern from PTH Quartile 1toQuartile 4 at all sites in children, with only minimal difference (decreasing trend) in serum25OHD levels between these quartiles. The critical level of parathyroid hormone beyond whichBMD going to decline is 35 pg/ml. No demonstrable difference has been observed in BMDwithin each PTH quartile according to categorization of Vitamin D Deficiency. Conclusions:Around 40% of the patients having low serum vitamin D level demonstrated SHPT. Regardingthe BMD levels, it begins to decreases at PTH levels currently well thought-out to be normal.So there is a need to re-define SHPT among different age groups considering the relationshiplinking PTH and BMD. This may also affect guidelines regarding vitamin d supplementation inpatients with vitamin D deficiency.

Influence of vitamin D deficiency on the bone mineral density in schoolchildren

2015 ◽  
Author(s):  
Vladyslav Povoroznyuk ◽  
Nataliya Balatska ◽  
Olga Tyazhka ◽  
Tetiana Budnik ◽  
Inga Kubey ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals P114 Effect of vitamin D on parathyroid hormone, serum calcium and bone mineral density in patients with primary hyperparathyroidism being managed conservatively

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mahrukh Khalid ◽  
Vismay Deshani ◽  
Khalid Jadoon
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Serum Calcium ◽  
Mineral Density ◽  
Neck Of Femur ◽  
Vitamin D Levels ◽  
Significant Difference

Abstract Background/Aims  Vitamin D deficiency is associated with more severe presentation of primary hyperparathyroidism (PTHP) with high parathyroid hormone (PTH) levels and reduced bone mineral density (BMD). We analyzed data to determine if vitamin D levels had any impact on PTH, serum calcium and BMD at diagnosis and 3 years, in patients being managed conservatively. Methods  Retrospective analysis of patients presenting with PHPT. Based on vitamin D level at diagnosis, patients were divided into two groups; vitamin D sufficient (≥ 50 nmol/L) and vitamin D insufficient (≤ 50 nmol/L). The two groups were compared for age, serum calcium and PTH levels at diagnosis and after mean follow up of 3 years. BMD at forearm and neck of femur (NOF) was only analyzed in the two groups at diagnosis, due to lack of 3 year’s data. Results  There were a total of 93 patients, 17 males, mean age 70; range 38-90. Mean vitamin D level was 73.39 nmol/L in sufficient group (n = 42) and 34.48 nmol/L in insufficient group (n = 40), (difference between means -38.91, 95% confidence interval -45.49 to -32.33, p &lt; 0.0001). There was no significant difference in age, serum calcium and PTH at the time of diagnosis. After three years, there was no significant difference in vitamin D levels between the two groups (mean vitamin D 72.17 nmol/L in sufficient group and 61.48 nmol/L in insufficient group). Despite rise in vitamin D level in insufficient group, no significant change was observed in this group in PTH and serum calcium levels. BMD was lower at both sites in vitamin D sufficient group and difference was statistically significant at NOF. Data were analyzed using unpaired t test and presented as mean ± SEM. Conclusion  50% of patients presenting with PHPT were vitamin D insufficient at diagnosis. Vitamin D was adequately replaced so that at 3 years there was no significant difference in vitamin D status in the two groups. Serum calcium and PTH were no different in the two groups at diagnosis and at three years, despite rise in vitamin D levels in the insufficient group. Interestingly, BMD was lower at forearm and neck of femur in those with sufficient vitamin D levels and the difference was statistically significant at neck of femur. Our data show that vitamin D insufficiency does not have any significant impact on PTH and calcium levels and that vitamin D replacement is safe in PHPT and does not impact serum calcium and PTH levels in the short term. Lower BMD in those with adequate vitamin D levels is difficult to explain and needs further research. Disclosure  M. Khalid: None. V. Deshani: None. K. Jadoon: None.

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