Osteoporosis of Indian men in their 60’s (perhaps low vitamin D, K, and Mg)

Created December 2016

High Prevalence of Osteoporosis and Morphometric Vertebral Fractures in Indian Males Aged 60 Years and Above: Should Age for Screening Be Lowered?

J Clin Densitom. 2016 Nov 30. pii: S1094-6950(16)30242-6. doi: 10.1016/j.jocd.2016.10.003. [Epub ahead of print]

Bhat KA1, Kakaji M1, Awasthi A2, Shukla M1, Dubey M1, Srivastava R1, Singh U2, Gupta SK3.

1 Department of Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.
2 Biostatistics and Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.
3 Dept of Endocrinology, Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow 226014, India. sushilguptasgpgi@gmail.com.

* Currently bone mineral density tests for male in India start at age 70 * 56% of all Indian asymptomatic males in their 60’s have Osteopenia * Study did not find a relationship between Bone Mineral Density and Vitamin D * Suspect it was because very few of the men had enough Vitamin D to make a difference * Study recommends BMD testing start at age 60 * VitaminDWiki recommends that Vitamin D should be added to prevent osteoporosis See also VitaminDWiki * Overview Osteoporosis and vitamin D * Bones not helped much by vitamin D (low dose or short term) National Osteoporosis Foundation – Feb 2016 * Vitamin D levels increasing 7 percent per year, bones denser in Japan (probably supplementation) - June 2015 * Osteoporosis Society UK: 20 ng vitamin D is sufficient, loading dose 300,000 IU – Sept 2014 * 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013 * Osteoporosis 2.8 X more likely if Vitamin D receptor (VDR) genes altered – Aug 2013] * Note: VDR problems are NOT detected by normal Vitamin D tests * European Osteo group recommends 20-50 ng of vitamin D – Jan 2013 * Note: The mean vitamin D level of the study on this page was just 17 ng Overview Osteoporosis and vitamin D contains the following summary {include} Osteoporosis category includes the following {include} Pages listed in BOTH the categories Bone and Magnesium {category} Pages listed in BOTH the categories Bone and Vitamin K2 {category}

Current guidelines recommend bone mineral density (BMD) measurement in asymptomatic men above age 70 years and vertebral fracture (VF) assessment above 80 years with T-score <-1.0 with risk factors. We studied the prevalence of osteoporosis and morphometric VF in asymptomatic males aged 60 years and above in North India. Free-living community-dwelling men (n = 241, age: mean ± standard deviation 68.0 ± 6.2 years) underwent a detailed history, physical examination, biochemical evaluation, and BMD measurements at 3 sites: lumbar spine, total hip (TH), and femoral neck (FN). Morphometric VF were assessed by instant vertebral assessment using Genant et al's semiquantitative method. We observed osteoporosis, osteopenia, and normal BMD in 19%, 56%, and 25% of subjects, respectively. The decade wise prevalence of osteoporosis in the age groups 60-70 years, 71-80 years, and >80 years was 16.9%, 17%, and 50%, respectively.

Mean serum 25OHD levels were 17.2 ± 10.3 ng/mL. Vitamin D deficiency (<20 ng/mL) and secondary hyperparathyroidism (plasma intact parathyroid hormone >65 ng/mL) were present in 68.8% and 45.4%, respectively. VF were present in 29.6% subjects (grade I: 58%, grade II: 32.4%, and grade III: 8.8%). Age and iPTH had significant negative correlation with BMD at FN and TH. Serum 25OHD had no correlation with BMD at any site. The prevalence of VF was positively associated with age (p = 0.018) and negatively associated with BMD at FN (p = 0.002) and TH (p = 0.013). Osteoporosis and VF are common in asymptomatic Indian males aged 60 years and above. Screening for osteoporosis and instant vertebral assessment may be recommended earlier than currently existing guidelines.

PMID: 27914693 DOI: 10.1016/j.jocd.2016.10.003 publisher wants $36 for the PDF

Tags: Osteoporosis