This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activities for this article:
 CME 4: October, November, December 2003
Basic Science Test 2: Bone Growth, Healing, Regeneration
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Glowacki, J.
Right arrow Articles by LeBoff, M. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Glowacki, J.
Right arrow Articles by LeBoff, M. S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery (American) 85:2371-2377 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Osteoporosis and Vitamin-D Deficiency Among Postmenopausal Women with Osteoarthritis Undergoing Total Hip Arthroplasty

Julie Glowacki, PhD1, Shelley Hurwitz, PhD1, Thomas S. Thornhill, MD1, Michael Kelly, BA1 and Meryl S. LeBoff, MD1

1 Departments of Orthopedic Surgery (J.G., T.S.T., M.K.) and Medicine (S.H. and M.S.L.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115

Investigation performed at the Departments of Orthopedic Surgery and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the United States Department of Defense. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Several epidemiological studies have shown a lower prevalence of osteoporotic hip fractures in patients with osteoarthritis. Other studies have demonstrated elevated bone mineral density in patients with osteoarthritis. The prevailing view is that there may be an inverse relationship between osteoarthritis and osteoporosis. The purposes of the present study were to describe a subgroup of patients with osteoarthritis who were found to have osteoporosis and to assess the vitamin-D status and other risk factors for low bone density in osteoarthritic subjects with and without osteoporosis.

Methods: The bone mineral density of the spine, the proximal part of the femur, and the total body was measured with dual-energy x-ray absorptiometry in sixty-eight postmenopausal white women who were scheduled to undergo total hip replacement for advanced osteoarthritis. The serum levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, and bone-specific alkaline phosphatase and the urinary level of N-telopeptide were measured. Information from validated lifestyle, dietary, and demographic questionnaires was also evaluated.

Results: Seventeen (25%) of the sixty-eight women had occult osteoporosis (as indicated by a T score of less than –2.5). Fifteen (22%) of the sixty-eight subjects had vitamin-D deficiency, and three (4%) had an elevated serum parathyroid hormone level. Only two of the seventeen osteoporotic women had vitamin-D deficiency. On the basis of these numbers, vitamin-D status was not correlated with bone density (p = 0.32). Analysis of the relationship between the number of years since menopause and osteoporosis or markers of elevated bone turnover showed that osteoporosis was detected throughout the postmenopausal period.

Conclusion: A substantial portion of these sixty-eight white women with osteoarthritis of the hip had occult osteoporosis and hypovitaminosis D. Vitamin-D deficiency was not restricted to the group with low bone density. These results support the need to consider the presence of both osteoporosis and vitamin-D deficiency in women with advanced osteoarthritis.

Level of Evidence: Therapeutic study, Level III-1 (case-control study). See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Age AgeingHome page
E. A. Lingard, S. Y. Mitchell, R. M. Francis, D. Rawlings, R. Peaston, F. N. Birrell, and A. W. McCaskie
The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty
Age Ageing, March 1, 2010; 39(2): 234 - 239.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
L. Gehrig, J. Lane, and M. I. O'Connor
Osteoporosis: Management and Treatment Strategies for Orthopaedic Surgeons
J. Bone Joint Surg. Am., June 1, 2008; 90(6): 1362 - 1374.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
D. M. Findlay
Vascular pathology and osteoarthritis
Rheumatology, December 1, 2007; 46(12): 1763 - 1768.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
M. I. O'Connor
Sex Differences in Osteoarthritis of the Hip and Knee
J. Am. Acad. Ortho. Surg., September 1, 2007; 15(suppl_1): S22 - S25.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
M. F. Holick
High Prevalence of Vitamin D Inadequacy and Implications for Health
Mayo Clin. Proc., March 1, 2006; 81(3): 353 - 373.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
S. Gaugris, R.P. Heaney, S. Boonen, H. Kurth, J.D. Bentkover, and S.S. Sen
Vitamin D inadequacy among post-menopausal women: a systematic review
QJM, September 1, 2005; 98(9): 667 - 676.
[Abstract] [Full Text] [PDF]