THE CLINICAL AND PROGNOSTIC VALUE OF HYPOVITAMINOSIS D IN POSTMENOPAUSAL OSTEOPOROSIS

Objective. To optimize the diagnosis and treatment of postmenopausal osteoporosis, by estimating the serum level of vitam in D 3. Subjects and methods. The study included 73 postmenopausal women who were divided into 2 groups according to the bone mineral density: 1) 53 patients with postmenopausal osteoporosis (a T-score of 4 -2.5 SD). The patients’ mean age was 58.5±4.4 years; the age of menopause onset was 49.4±6.05 years. The duration of menopause was 9.26±6.05 years. Group 2 was a comparison one (bone mineral density, > -1.0 SD; no history of fractures). The patients’ mean age was 57.8 ±5.5 years; the age of menopause onset was 49.6±3.8 years. The duration of menopause was 8.3±5.6 years. Bone mineral density was screened using dual-energy X-ray absorptiometry of the vertebra of the lumbar spine and femoral neck. Enzyme immunoassay was used to measure the baseline serum level of 25(OH) vitamin D. Results. Most (82%) postmenopausal women were found to have vitamin D 3 deficiency regardless of their bone mineral density. The standard daily dose of 800 IU is inadequate to maintain vitamin D 3 levels in the normal range as part of combination therapy in most patients with postmenopausal osteoporosis. Presaturation with cholecalciferol in a dose of 5000 IU/day can achieve the normal values of 25(ОН) vitamin D in 88% of the patients following 12 weeks. Further maintenance therapy with cholecalciferol 800 IU/day for 12 months is accompanied by the retained reference values of vitamin D 3 in 44.4% of the women. Conclusion. Most (82%) postmenopausal women have 25(OH) hypovitaminosis D regardless regardless of the bone mineral density. Estimation of 25(ОН) vitamin D levels makes it possible to identify patients with hypovitaminosis D and to monitor cholecalciferol therapy. Twelve-week therapy with cholecalciferol 5000 IU/day permits an increase in 25(ОН) vitamin D levels up to > 20 ng/ml in 88% of the patients with postmenopausal osteoporosis and hypovitaminosis D. The maintenance cholecalciferol dose of 800 IU/day is insufficient in the combination therapy of postmenopausal osteoporosis.

cholecalciferol doses, correction of hypovitaminosis D