Vitamin D status in patients with osteopenia or osteoporosis - an audit of an endocrine clinic

Vitamin D deficiency and insufficiency may further increase fracture risk in patients with decreased bone mineral density. We audited serum 25-hydroxyvitamin D (250HD) concentrations in patients with osteopenia or osteoporosis attending endocrine osteoporosis clinics in North London between January 1998 and September 2001. The total number of patients analyzed was 448 (age range 17-89 years), with 191 patients being < 50 years old (42.6%). The following cut-off points for serum 250HD were used: levels <= 30 nmol/L for deficiency, > 30-50 nmol/L for insufficiency, and > 50 nmol/L for sufficiency, The overall prevalence of vitamin D deficiency was 30.5% and of vitamin D insufficiency was 35.9%. Vitamin D deficiency was as prevalent in young patients as in older ones: the prevalence of serum 250HD <= 30 nmol/L in those < 50 years of age was 33.0% (n = 63 of 191), compared with 31.1% (n = 80 of 257) in patients aged >= 50 years. Our results indicate that vitamin D deficiency and insufficiency is a common problem in patients with osteopenia or osteoporosis. This situation persists despite dietary advice and prescription of vitamin D-3 supplementation. Vitamin D deficiency affects all age groups, not merely the elderly.