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QJM Advance Access originally published online on July 8, 2005
QJM 2005 98(9):667-676; doi:10.1093/qjmed/hci096
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Vitamin D inadequacy among post-menopausal women: a systematic review

S. Gaugris1, R.P. Heaney2, S. Boonen3, H. Kurth4, J.D. Bentkover4 and S.S. Sen5

From the 1Rutgers University, Piscataway, USA, 2Creighton University, Omaha, USA, 3Leuven University Center for Metabolic Bone Diseases and Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium, 4Innovative Health Solutions Corporation, Brookline, USA, and 5Outcomes Research Department, Merck & Company, Whitehouse Station, USA

Address correspondence to Dr S.S. Sen, Outcomes Research, Merck & Co. Inc., One Merck Drive—WS2E-76, Whitehouse Station, NJ 08889, USA. email: shuvayu_sen{at}merck.com

Received 3 December 2004 and in revised form 2 June 2005

Background: Vitamin D inadequacy has been studied extensively, due to concerns about ageing populations, associations with osteoporosis and other disorders (including non-musculoskeletal), and high prevalence.

Aim: To review recent reports on the prevalence of vitamin D inadequacy among post-menopausal women with and without osteoporosis and/or other musculoskeletal diseases.

Design: Systematic review.

Methods: We reviewed publications in the past 10 years reporting prevalence estimates for vitamin D inadequacy, reported as serum 25(OH)D values below various levels. Thirty published studies in the English language were identified, from January 1994 through April 2004.

Results: In osteoporotic populations, the prevalence of 25(OH) vitamin D concentration <12 ng/ml ranged from 12.5% to 76%, while prevalence rates reached 50% to 70% of patients with a history of fracture(s) using a cut-off of 15 ng/ml. In post-menopausal women, the prevalence of 25(OH) vitamin D concentrations <=20 ng/ml ranged from 1.6% to 86% for community-living and institutionalized women, respectively. The most common factors associated with inadequate vitamin D levels included limited sun exposure, lack of dietary vitamin D intake, nursing home environment, wintertime, and increasing age (over 70 years).

Discussion: The prevalence of inadequate vitamin D levels appears to be high in post-menopausal women, especially in those with osteoporosis and history of fracture. Vitamin D supplementation in this group might offer scope for prevention of falls and fracture, especially in elderly and osteoporotic populations.


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