Vitamin D status and response to treatment in post-menopausal osteoporosis

Adami, Silvano; Giannini, Sandro; Bianchi, Gerolamo; Sinigaglia, Luigi; Munno, Ombretta Di; Fiore, Carmelo Erio; Minisola, Salvatore; Rossini, Maurizio

doi:10.1007/s00198-008-0650-y

Cited by 216 publications

(125 citation statements)

References 18 publications

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“…Our study shows that there is low percent agreement between the patients' report of calcium, vitamin D, and multivitamin supplementation and physician documentation of these supplements. This is consistent with previous studies that have documented that it is common for medication lists in an EHR to have inaccuracies, especially with regard to medications that are available over the counter [13,14]. One study showed that 43% of the medications listed in the EHR were inaccurate and more than three times as many over-the-counter drugs than prescription medications were missing from the EHR [13].…”

Section: Discussionsupporting

confidence: 89%

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Silva¹,

Romeiser²,

Baker³

et al. 2013

OJPM

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Introduction: Optimal calcium and vitamin D intake is important components of the treatment of osteoporosis. The national average calcium and vitamin D intake for women over age 50 is below the recommended levels for optimal bone health. The aim of this study was to assess whether deficiencies in calcium and vitamin D intake exist in women with osteoporosis in a general medicine practice, as well as evaluate whether physicians accurately document calcium and vitamin D supplementation in the health record. Methods: Using the Electronic Health Record (EHR), we identified all female patients age 50 and older with the diagnosis of osteoporosis who were seen at the study site clinic, an urban academic general medicine practice, between January 1 st , 2010 and December 1 st , 2010. Women were randomly selected to receive an invitation to participate in a telephone survey on osteoporosis treatment. Results: One hundred and sixteen women completed the telephone survey. The mean calcium intake was 1524 mg per day. Forty-nine percent of women surveyed reported taking less than 1200 mg/day of supplemental calcium. When considering reported calcium intake from diet, 33% percent consumed less than 1200 mg/day and 52% percent consumed more than 1500 mg/day. Twenty eight percent of patients were taking less than 800 IU/day of vitamin D; only four percent were taking more than 4000 IU/day. Agreement between patients' self-reported intake of calcium, vitamin D and multivitamin supplements and physicians' documentation of these supplements was 52% for calcium, 53% for vitamin D and 61% for multivitamin. Conclusion: Among women with osteoporosis getting regular care in a general medicine practice, approximately a third are getting less than the recommended daily amount of calcium and a quarter less than the recommended amount of vitamin D. In addition, a significant proportion of women are getting excessive daily amounts of calcium, which may also be a quality concern. Rates of agreement between self-reported calcium and vitamin D supplements and chart documentation of these supplements were low.

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Section: Discussionsupporting

confidence: 89%

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Silva¹,

Romeiser²,

Baker³

et al. 2013

OJPM

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“…Reports from other countries indicated serum 25(OH)D levels less than 30-32 ng/mL were associated with poorer BMD responses to bisphosphonates and selective estrogen receptor modulators or with increased fracture incidence during anti-osteoporotic pharmaceutical treatment [25][26][27][28].…”

Section: ) Responsiveness To Antiresorptive Medicationsmentioning

confidence: 99%

Assessment criteria for vitamin D deficiency/insufficiency in Japan — proposal by an expert panel supported by Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, The Japanese Society for Bone and Mineral Research and The Japan Endocrine Society [Opinion]

et al. 2017

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Abstract. Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world. In Japan, however, the information on the associations between serum 25(OH)D and bone and mineral disorders has not been widely shared among healthcare providers, partly because its measurement had not been reimbursed with national medical insurance policy until August 2016. We have set out to collect and analyze Japanese data on the relationship between serum 25(OH)D concentration and bone and mineral events. Integrating these domestic data and published guidelines worldwide, here we present the following assessment criteria for vitamin D sufficiency/insufficiency/deficiency using serum 25(OH)D level in Japan. 1) Serum 25(OH)D level equal to or above 30 ng/mL is considered to be vitamin D sufficient. 2) Serum 25(OH)D level less than 30 ng/mL but not less than 20 ng/mL is considered to be vitamin D insufficient. 3) Serum 25(OH)D level less than 20 ng/mL is considered to be vitamin D deficient. We believe that these criteria will be clinically helpful in the assessment of serum 25(OH)D concentrations and further expect that they will form a basis for the future development of guidelines for the management of vitamin D deficiency/insufficiency. [1][2][3][4][5]. In Japan, however, the information

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“…Vitamin D levels below the optimal range limit dietary absorption of calcium, lead to secondary hyperparathyroidism with loss of skeletal calcium to maintain normocalcemia, contribute to falling risk in the elderly, 29 and blunt the bone mineral density (BMD) response and antifracture efficacy of bisphosphonates. 30 Although currently available data offer no consensus on optimal serum levels of 25-hydroxyvitamin D (the storage form of vitamin D that best reflects vitamin D status), a level of 30 ng/mL (to convert to nmol/L, multiply by 2.496) is generally considered adequate; vitamin D intoxication occurs only when levels are higher than 150 ng/mL. 31 The National Osteoporosis Foundation recommends an optimal calcium intake for both men and women younger than 50 years of 1000 mg/d, with an increase to 1200 mg/d for those 50 years and older.…”

Section: Subtrochanteric Femoral Fracturesmentioning

confidence: 99%

Adverse Effects of Bisphosphonates: Implications for Osteoporosis Management

Kennel

Drake

2009

Mayo Clinic Proceedings

228

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Vitamin D status and response to treatment in post-menopausal osteoporosis

Abstract: Optimal vitamin D repletion seems to be necessary to maximize the response to anti-resorbers in terms of both BMD changes and anti-fracture efficacy.

Cited by 216 publications

References 18 publications

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Assessment criteria for vitamin D deficiency/insufficiency in Japan — proposal by an expert panel supported by Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, The Japanese Society for Bone and Mineral Research and The Japan Endocrine Society [Opinion]

Adverse Effects of Bisphosphonates: Implications for Osteoporosis Management

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Vitamin D status and response to treatment in post-menopausal osteoporosis

Abstract: Optimal vitamin D repletion seems to be necessary to maximize the response to anti-resorbers in terms of both BMD changes and anti-fracture efficacy.

Cited by 216 publications

References 18 publications

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Overuse and underuse of calcium and vitamin D in women with osteoporosis: A survey in a primary care setting

Assessment criteria for vitamin D deficiency/insufficiency in Japan &mdash; proposal by an expert panel supported by Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, The Japanese Society for Bone and Mineral Research and The Japan Endocrine Society [Opinion]

Adverse Effects of Bisphosphonates: Implications for Osteoporosis Management

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Assessment criteria for vitamin D deficiency/insufficiency in Japan — proposal by an expert panel supported by Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, The Japanese Society for Bone and Mineral Research and The Japan Endocrine Society [Opinion]