Summary This study evaluated the association of vitaminD and
bone markers with the development osteoporosis in Palestinian
postmenopausal women. Even though vitamin D deficiency
was very high for the recruited subjects, it was not associated
with osteoporosis except for bones of the hip. Age and obesity
were the strongest determining factors of the disease.
Purpose The purpose of this study was to investigate the association
of bone mineral density (BMD) with serum vitamin
D levels, parathyroid hormone (PTH), calcium, obesity, and
bone turnover markers in Palestinian postmenopausal women.
Methods Three hundred eighty-two postmenopausal women
(≥45 years) were recruited from various women clinics for
BMD assessment (131 women had osteoporosis and 251 were
normal and served as controls). Blood samples were obtained
for serum calcium, PTH, 25(OH)D, bone formation (N-terminal
propeptide (PINP)), and bone resorption (serum Cterminal
telopeptide of type I collagen (CTX1)) markers.
Results Women with osteoporosis had statistically significant
lower mean weight, height, body mass index (BMI), and serum
calcium (p < 0.05) compared to controls. No significant
differences were detected between the mean values of bone
turnover markers (CTX and PINP), 25(OH)D, and PTH of
the two groups. Women with vitamin D deficiency (severe
and insufficiency) represented 85.9% of the study subjects.
Multiple and logistic regression showed that age and BMI
significantly affected BMD and vitamin D had a significant
association with BMD only at the lumbar spine. BMI was
positively correlated with BMD and PTH but negatively
correlated with vitamin D. Logistic regression showed that
the odds ratio (OR) for having osteoporosis decreased with
increasing BMI (overweight OR = 0.11, p = 0.053; obese
OR = 0.05, p = 0.007).
Conclusions There was no direct correlation between BMD
and PTH, bone turnover markers, and vitamin D except at the
lumbar spine. A negative correlation between BMD and age
and a positive correlation with BMI were observed. The protective
effect of obesity on osteoporosis was complicated by
the effect of obesity on vitamin D and PTH.