Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis

AIM The aim of this study was to determine whether the presence of Vitamin D insufficiency increases bone turnover and enhances bone lass by examining the relationship between bone turnover markers and Bone mineral density (B MD) in vitamin D insufficient and vitamin D sufficient patients, with estab lished vertebral osteoporosis. SUBJECTS 119 consecutive, active, community dwelling, elderly women were as sessed over a 7-month period between the months of March to October. RESULTS There was a significant correlation between parathyroid hormone (PT H) and 25 hydroxyvitamin D (25(OH)D), r=-0.42 (P<0.01). The prevalence of v itamin D insufficiency was 26.9% (defined by a 25(OH)D greater than or equa l to 6.1 mu g/l and less than or equal to 12 mu g/l). This resulted in a st atistically significant increase in bone turnover markers compared to the V itamin D sufficient group: bone alkaline phosphatase (P< 0.05), osteocalcin (P< 0.01), hydroxyproline (P<0.05), free deoxypyridinoline (P<0.05) and lo wer bone mineral density at the total hip (P<0.01). CONCLUSIONS These results show that there is a high prevalence of vitamin D insufficiency in the active community dwelling elderly with established ve rtebral osteoporosis presenting to clinical attention, which leads to incre ased bone turnover, decreased BMD at the hip and thus enhanced risk of furt her osteoporotic fractures in comparison with vitamin D sufficient subjects .