Survey of vitamin D levels among post-menopausal Filipino women with osteoporosis.

OBJECTIVE: To determine the prevalence of vitamin D inadequacy in a group of Filipino post-menopausal women with osteoporosis. METHODS: Seventy otherwise healthy post-menopausal Filipino women seen at the University of Santo Tomas Hospital, Section of Rheumatology, were diagnosed with osteoporosis by central dual-energy X-ray absorptiometry (DXA) technique. Levels of serum 25-hydroxyvitamin D were measured using enzyme-linked immunosorbent assay. RESULTS: The mean age of this population was 70 +/- 8 years, with an average of 22 +/- 10 years since menopause, and mean body mass index (BMI) of 22 +/- 1 kg/m(2). Only 30% (21/70) were on calcium plus vitamin D supplementation. Overall serum 25-hydroxyvitamin D levels ranged from 48-128 nmol/L, with a mean of 87 +/- 20.48 nmol/L. Serum 25-hydroxyvitamin D levels were divided as follows: 80-140 nmol/L (adequate), 25-79 nmol/L (inadequate/insufficient), and < 25 nmol/L (deficient). Sixty-four percent (45/70) of subjects had adequate levels while 36% (25/70) had inadequate levels of 25-hydroxyvitamin D. There were no subjects with deficient levels of 25-hydroxyvitamin D. Fischer's exact test did not show a significant association between BMD and 25-hydroxyvitamin D (P = 0.4804). CONCLUSION: Among this group of women with post-menopausal osteoporosis, only 36% had insufficient levels of 25-hydroxyvitamin D, with none of the subjects having deficient 25-hydroxyvitamin D levels. The majority (64%) had normal serum 25-hydroxyvitamin D levels--comparatively higher than that reported in the literature. These results suggest the possible contribution of factors other than vitamin D deficiency in post-menopausal Filipino women with osteoporosis.

Does prolonged systemic glucocorticoid use increase risk of tophus formation among gouty arthritis patients?

AIM: To determine the relationship of steroid use with tophus formation and other comorbid conditions among male gout patients. METHODS: Review of medical records of Filipino gout patients under the care of rheumatologists was conducted. Univariate analysis (chi-square, Student's t-test) and multiple logistic regression analysis were performed to establish the risk for tophus formation among glucocorticoid users. Bivariate analysis was separately done to determine the confounding effect of steroid use in the association of comorbidities and tophi formation. RESULTS: There were 295 Filipino men with a mean age of 56 years and a mean duration of 12 years of gouty arthritis who were included in the study. Multivariate analysis showed a five times higher likelihood (OR 4.81 95% CI 1.92-12.04, P < 0.001) for tophus formation among prolonged steroid users. Confounders identified were disease duration of gout (> or = 10 years), presence of chronic kidney disease (CKD) and elevated serum creatinine level (SCr). Bivariate analysis of comorbidities showed that steroid use introduced a considerable bias in the relationship of hypertension, elevated SCr, CKD and dyslipidemia. CONCLUSION: Patients with equivalent prednisone intake of at least 15 mg/week for > or = 3 months is associated with tophi formation. In the presence of hypertension, renal impairment, and elevated serum creatinine level, use of steroids confounds the individual risk that each factor carries.