POSTMENOPAUSAL VITAMIN D SCREENING AND INITIATION OF TREATMENT

Abstract

INTRODUCTION/BACKGROUND
Menopause induces bone density loss due to oestrogen deficiency, predisposing women to osteoporosis and fractures. It is estimated that of the 200 million women affected globally, 50% are post-menopausal. Vitamin D deficiency further compounds bone healing. Recent metaanalyses show that over half the Malaysian population has inadequate levels of Vitamin D, underscoring the need for proactive measures in women's health screening. Initiating anti-resorptive medication during the early post-fracture period has in the past raised concerns about fracture healing, however, recent studies do not reflect this. The preponderance of available data suggests that antiresorptives are safe to be initiated as early as 1-2 weeks post-fracture.

METHODOLOGY
We examined the awareness of screening for Vitamin D deficiency and the time to initiation of treatment within this demographic. This is a retrospective study among women with postmenopausal osteoporotic fractures seen from the years 2022 to 2023 in Hospital Putrajaya, looking into screening for Vitamin D deficiency and the timing of initiation of definitive osteoporotic treatment.

RESULTS
Of the total of 101 patients screened from various departments, including endocrinology, rheumatology, orthopaedics and gynaecology, 20 patients (19.8%) with osteoporotic fractures were not screened for Vitamin D deficiency. Among the 81 screened patients, 54.3% were Vitamin D deficient, of which 2.4% were severely deficient. Furthermore, 77.2% of patients were found to have initiated osteoporosis treatment beyond two weeks after the fracture.

CONCLUSION
This study showed most patients were screened for Vitamin D deficiency, but its high prevalence should be considered. The study also shows that osteoporosis treatment was initiated beyond two weeks post fracture in majority of our patients.