25-hydroxy vitamin D levels, vitamin D deficiency and insufficiency in patients with bone and musculoskeletal disorders
Background. Vitamin D deficiency is prevalent in all the world countries. Recent studies show the correlation between vitamin D deficiency and musculoskeletal disorders. The purpose of this study is to examine vitamin D deficiency and insufficiency prevalence in patients of various ages, who have musculoskeletal disorders, and to reveal the influence of seasonal factors on these conditions. Materials and methods. 3460 patients of the Ukrainian Scientific Medical Center of Osteoporosis Problems, aged 1 to 92 years, who were referred by other specialists to the center for bone state evaluation, were examined. A majority of the patients presented with osteoporosis and its complications, spinal osteochondrosis, knee and hip osteoarthritis (mean age — 52.90 ± 21.10 years). Most of the patients were women (83.5 %). 25(ОН)D and parathyroid hormone analyses were performed by means of electrochemiluminescent method (Elecsys 2010 analyzer, Roche Diagnostics, Germany) and cobas test-systems. Statistica 6.0 software package (Copyright StatSoft, Inc., 1984–2001) was also used. Results. Among the patients with musculoskeletal pathology, the highest 25(ОН)D level was noted in the age group of 1–9 years and the lowest — in the age group of 80 and over. Age negatively influenced 25(ОН)D values. Prevalence of vitamin D deficiency among the patients with musculoskeletal pathology was 37.3 %, vitamin D insufficiency — 30.6 %; 32.1 % of patients had normal vitamin D status. Normal 25(OH)D level was found in 38.0 % of children, 33.2 % of adults and in 29.6 % of elderly patients. Month of blood sampling had a significant influence on 25(ОН)D content (F = 7.49; p < 0.001). The highest significant differences in 25(ОН)D levels during the summer vs. winter months were observed in the age groups of 10–19 (18.2 %), 40–49 (17.3 %), 30–39 (16.2 %) и 1–9 years (16.1 %). There were no significant seasonal differences observed in the elderly patients (60 years and older) with musculoskeletal pathology. Conclusions. Despite the combined calcium and vitamin D supplementation in most patients with musculoskeletal pathology, only 37.9 % of children, 33.2 % of adults and 29.6 % of the elderly people had normal 25(ОН)D values and thus required screening examination of vitamin D level in patients with musculoskeletal disorders and additional vitamin D prescription (Guidelines for the Central and Eastern Europe).
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