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Most intervention studies have excluded African Americans because of the erroneous belief that osteoporosis is not a major health problem in this population.
Since longevity is increasing in the black population, osteoporotic fractures will become an even greater problem for this ethnic minority in the future. Furthermore, morbidity and mortality from osteoporotic fractures is greater in blacks.
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The elderly require higher intake of vitamin D to prevent bone loss resulting from secondary hyperparathyroidism. Calcium with sufficient vitamin D supplementation may decrease fractures in elderly white populations as a result of reduction in bone loss and falls improved physical performance. The only fracture intervention study to include African Americans-the Women's Health Initiative-used an inadequate dose of vitamin D IUa dose unlikely to achieve the vitamin D status proposed by U.
As a result of increased skin pigmentation, blacks synthesize less vitamin D from sun exposure. As a result, serum 25 OH Escort union city clasificados levels are often in the "insufficient" range.
This is accompanied by secondary hyperparathyroidism, but adult blacks have a relative skeletal resistance to PTH, so that they have bkack bone turnover. They also have more efficient renal conservation of calcium starting in childhood. Addition of vitamin D3 to a calcium-sufficient African American postmenopausal population does not prevent bone loss.
However, the elderly require more vitamin D to produce the higher 25 OH D levels required to overcome the hyperparathyroidism associated with aging. The skeleton of elderly African Americans appears to be susceptible to the increasing parathyroid hormone levels of old age.
Bone loss accelerates and bone turnover markers increase in elderly African Americans just as in whites. Adequate calcium intake will be ensured.
Functional markers of vitamin D including bone density, serum PTH, and bone turnover will be measured.