Archives of Osteoporosis

, 13:111 | Cite as

Serum 25-hydroxyvitamin D status, quantitative ultrasound parameters, and their determinants in Greek population

  • Effimia V. Grigoriou
  • George Trovas
  • Nikolaos Papaioannou
  • Polyzois Makras
  • Panagiotis Kokkoris
  • Ismene Dontas
  • Konstantinos Makris
  • Symeon Tournis
  • George V. DedoussisEmail author
Original Article



Vitamin D deficiency and quantitative ultrasound measurements are associated with bone fragility. We assessed these parameters and their correlates. 87.7% of the population has vitamin D inadequacy and this correlated with lifestyle factors. These results contribute to epidemiological data needed for population guidelines for bone health.


Vitamin D deficiency and quantitative ultrasound (QUS) parameters are among the most important clinical risk factors of bone fragility. Few data are available for Greek population. The aim of the study was to evaluate the serum 25-hydroxyvitamin D [25(OH)D] level and their determinants, as well as QUS parameters in Greek population.


OSTEOS is an observational cross-sectional study conducted from June 2010 to July 2012. Nine hundred seventy adults were recruited from rural and urban areas throughout Greece and completed the appropriate questionnaire. Serum 25(OH)D measured by enzyme immunoassay, QUS parameters, broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI), was assessed with an Achilles device. Univariate Analysis of Variance was used for the assessment of serum 25(OH)D determinants.


Mean serum 25(OH)D of the total population was 20,00 ± 8,00 ng/mL. Females had lower levels than males. The negative determinants of serum 25(OH)D in the total population were the female sex and the winter-spring season of sampling while age proved negative association solely in obese subjects. Positive determinants of vitamin D status were summer sun exposure and organized physical activity as expected. Urban had lower SOS and SI than rural residents. Individuals with 25(OH)D ≥ 20 ng/mL had higher SOS than those with 25(OH)D < 20 ng/mL. BUA, SOS, and SI are positively correlated with organized physical activity and negatively with PTH.


This study reports that vitamin D deficiency is highly prevalent among healthy Greek men and women, demonstrates the multifactorial causation of 25(OH)D levels, and points out that further research is required to determine more factors related to vitamin D status and bone health.


Vitamin D Life-style factors Heel bone properties Epidemiology 



The authors thank the Hellenic Society for the Support of Patients with Osteoporosis and all the dietitians and clinicians for their contribution to the project.

Special thanks to post doc researcher Maria Stathopoulou for her contribution to the study design and the dietitian Evangelia Bitsani for the subject recruitment.

Funding information

This study was partially supported by a research grant from the Hellenic Society for the Study of Bone Metabolism.

Compliance with ethical standards

Conflicts of interest


Supplementary material

11657_2018_526_MOESM1_ESM.doc (53 kb)
ESM 1 (DOC 53 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Effimia V. Grigoriou
    • 1
  • George Trovas
    • 2
  • Nikolaos Papaioannou
    • 2
  • Polyzois Makras
    • 3
    • 4
  • Panagiotis Kokkoris
    • 3
    • 4
  • Ismene Dontas
    • 2
  • Konstantinos Makris
    • 5
  • Symeon Tournis
    • 2
  • George V. Dedoussis
    • 1
    Email author
  1. 1.Department of Nutrition and Dietetics, School of Health Science and EducationHarokopio UniversityAthensGreece
  2. 2.Th. Garofalidis Laboratory for Research of the Musculoskeletal System, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  3. 3.Department of Endocrinology and Diabetes251 Hellenic Air Force General HospitalAthensGreece
  4. 4.Department of Medical Research251 Hellenic Air Force & VA General HospitalAthensGreece
  5. 5.Department of BiochemistryKAT General HospitalAthensGreece

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