TITLE:
Vitamin D Deficiency and Pseudofractures in Child-Bearing Egyptian Women: Successful Medical Treatment Helps to Avoid Fractures and Surgical Interference
AUTHORS:
Ghada M. El-Sagheer, Elwy Soliman, Ahlam M. Abdulla, Mohamed Ali
KEYWORDS:
Hypovitaminosis D, Osteomalacia, Looser Zone
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.6 No.8,
August
10,
2016
ABSTRACT: Background:
Recent evidence for the effects of vitamin D and recognition of the high
prevalence of its deficiency has increased the interest in it. Vitamin D-sub
nutrition may contribute to the risk of a wide range of disorders. Methods: The
females in the child-bearing period attending the endocrinology and orthopedic
out-patient clinics complaining of pain and/or tenderness at the groin were
evaluated. Patients with chronic metabolic or skeletal illness, primary
hyperparathyroidism, andpatients
receiving drugs that interfere with bone mineral metabolisms were excluded. One
hundred accepted and consented to participation in the study. All the
participants were subjectedto
full history taking, clinical evaluation, laboratory investigations including
serum Ca, Ph, PTH,ALP, TSH, F
T4, F T3, Cortisol level, and 25(OH)D level. Plain X-ray was done for the
regions of bony tenderness. The subjects were divided into 2 groups based on
the presenceor absence ofpseudo-fractures (looser zones). They
were treated and followed up till normalization of the laboratory parameters
and healing of the looser zones. Results: The mean age for patients was 30.45 ±
5.8, their mean 25(OH) vitamin D level was 14.7 ± 5.9 ng/ml, the mean PTH was
195.7 ± 162.6, and looser zones were evident in the X-rays of 34 patients. The
serum 25(OH)D showed significant negative correlations with veiling, parity,
localized hip pain, and tenderness, ALP, PTH, but, a significant positive
correlation with sun exposure, dairy products consumption, vitamin D
supplementation, and serum calcium levels. The independent factors associated
with hypovitaminosis D were the lack of sun exposure, lack of vitamin D
supplementation, and the presence of pseudo- fracture (p ≤ 0.009, 0.038, and
0.001 respectively). No surgery was required in any of our patients.
Conclusions: Vitamin D deficiency is common in our region. The main risk
factors are decreased sun exposure, low dairy products consumption, and lack of
vitamin D supplementation. Successful medical treatment may be helpful to
satisfy the patient, avoid true fracture and further major surgical treatments.