ORIGINAL COMMUNICATION High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina B Oliveri 1 *, L Plantalech 2 , A Bagur 1 , AC Wittich 3 , G Rovai 4 , E Pusiol 5 , J Lo ´ pez Giovanelli 6 , G Ponce 7 , A Nieva 8 , A Chapero ´n 9 , M Ladizesky 1 *, J Somoza 1 , C Casco 1 , S Zeni 1 *, MS Parisi 1 ** and CA Mautalen 1 Research Comite´e of the Asociacio´n Argentina de Osteologı´a y Metabolismo Mineral (AAOMM), 1 Seccio´n Osteopatı´as Me´dicas, Hospital de Clı´nicas, Universidad de Buenos Aires, Buenos Aires, Argentina; 2 Hospital Italiano, Buenos Aires, Argentina; 3 Hospital Centro de Salud Tucuma´n, Argentina; 4 Corrientes, Argentina; 5 Mendoza, Argentina; 6 Bariloche, Argentina; 7 Universidad Nacional de la Patagonia San Juan Bosco, Argentina; 8 Centro de Estudios de Osteoporosis Comodoro Rivadavia, Argentina; and 9 Sanatorio San Jorge Ushuaia, Argentina Objective: To evaluate the nutritional status of vitamin D in urban populations of healthy elderly people living at home, in different regions of Argentina. Design: Cross-sectional study. Subjects: In total, 386 ambulatory subjects over 65 y of age from seven cities (between latitude 261S and 551S) were asked to participate between the end of winter and the beginning of spring. Of these, 369 accepted, 30 were excluded because of medical history or abnormal biochemical determinations. Finally, 339 subjects (226 women and 113 men) (X7s.d.) (71.37 5.2 y) were included. Results: Serum 25OHD levels were lowest in the South (latitude range: 411S–551S): 14.275.6 ng/ml (Po0.0001vs North and Mid regions); highest in the North (261S–271S): 20.777.4 ng/ml (Po0.03 vs Mid, Po0.0001vs South); and intermediate in the Mid region (331S–341S) 17.978.2 ng/ml. Serum mid-molecule PTH (mmPTH) and 25OHD were inversely related: (r ¼0.24, Po0.001). A cutoff level of 25OHD at which serum mmPTH levels began to increase was established at 27 ng/ml. A high prevalence (87–52%) of subjects with 25OHD levels in the deficiency-insufficiency range (25OHD levels o20 ng/ml) was detected. Conclusion: This study shows that vitamin D deficiency/insufficiency in the elderly is a worldwide problem. Correction of this deficit would have a positive impact on bone health of elderly people. Sponsorship: Asociacio ´ n Argentina de Osteologı ´a y Metabolismo Mineral (AAOMM). European Journal of Clinical Nutrition (2004) 58, 337–342. doi:10.1038/sj.ejcn.1601786 Keywords: vitamin D insufficiency/deficiency; secondary hyperparathyroidism; elderly people Introduction Vitamin D insufficiency is common in elderly populations (particularly in institutionalized subjects) (Mc Kenna, 1992) and leads to secondary hyperparathyroidism, high bone turnover, bone loss and osteoporotic fractures (Brazier et al, 1995; Chapuy et al, 1996; Dawson-Hughes et al, 1997; Le Boff et al, 1999). Different categories have been proposed to classify vitamin D status: vitamin D deficiency that leads to osteomalacia, with the ensuing histomorphometric changes (Parfitt et al, 1982), vitamin D insufficiency that has an effect on calcium homeostasis, such as a diminution in calcium absorption and 1,25(OH)2D levels, leading to secondary hyperparathyroidism (Peacock et al, 1985), and vitamin D sufficiency with no effect on calcium homeostasis. The threshold of serum 25OHD that separates vitamin D Received 13 January 2003; revised 24 March 2003; accepted 23 April 2003 *Correspondence: B Oliveri, Seccio ´ n Osteopatı ´as Me ´dicas, Hospital de Clı ´nicas, Co ´ rdoba 2351(1120) Buenos Aires, Argentina. E-mail: osteologia@ciudad.com.ar Guarantor: Beatriz Oliveri. Contributors: BO, LP and AB took part in the protocol design, and writing and editing of the report. ML took part in the protocol design. CM took part in the writing and editing of the report. MSP carried out statistical analysis and participated in writing the report. AW, GR, EP, JLG, GP, AN and AC participated in recruiting the patients and analyzing their data. SZ, CC and JS provided the biochemical intervention. *Researcher of the National Council for Scientific and Technological Research (CONICET). **Fellow of the National Council for Scientific and Technological Research (CONICET). European Journal of Clinical Nutrition (2004) 58, 337–342 & 2004 Nature Publishing Group All rights reserved 0954-3007/04 $25.00 www.nature.com/ejcn