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Background Studies have previously demonstrated that ultrasound detected power Doppler (PD) activity (implying active synovial inflammation) may be present in a proportion of patients in clinical remission 1,2 and this can be used to accurately predict subsequent radiographic structural progression. 3 It may be hypothesised that such continued subclinical inflammation despite apparent remission as determined by traditional criteria may trigger a subsequent disease flare. Objectives Our study aimed to determine subclinical joint inflammation in patients with rheumatoid arthritis by power Doppler ultrasound in patients with rheumatoid arthritis at 12 months of adalimumab therapy. Methods Patients with RA who had received adalimumab therapy were enrolled. Patients underwent clinical, laboratory, and ultrasonographic assessment with power Doppler assessment of bilateral elbows (posterior recess), wrists (radio-carpal), second and third MCP joints (dorsal recess), MCP II and III, PIP II and III (dorsal recess), knee, ankle and MTPII and MTP V joint at 12th month. Results Power Doppler ultrasound was performed in 62 patients (87 females and 18 males; mean age: 57.09±9.96 years). The mean baseline DAS28 were 8.13±9.52. Baseline PD score (mean ±SD) were 0.852 ±1.051 and after 12 month of adalimumab therapy, the PD score decreased to 0.23±0.42. Ultrasound was performed 12th month at various parts, with the mean GS score: most prominent at right wrist (.810±.924) and left wrist (.774±.909) (Table).Logistical regression confirmed diabetes, positive anti-CCP, high DAS28 had more sonographic inflammation, while hypertension and positive rheumatoid factor (RF) had less sonographic inflammation. MTX, glucocorticoid and cyclosporin therapy had increased inflammation. Conclusions Our data confirm the evidence that even after 1 year of biological therapy, there were still persistent subclinical synovitis, more severe at wrist joints. Baseline high DAS28 and high PD activity had more prone to residual inflammation. So we recommended serial ultrasound follow up of PD ultrasound in patients with rheumatoid arthritis after adalimumab therapy. References Saleem B, et al. Arthritis Rheum. 2009;60(7):1915–22. Brown AK, et al. Arthritis Rheum. 2006;54(12):3761–73. Brown AK, et al. Arthritis Rheum. 2008;58(10):2958–67. Disclosure of Interest None declared

Background In previous studies, the patients achieved greater disease control by adalimumab at 24 weeks, this response was maintained over the next 24 weeks 1 , however, we could not found the characteristic in image to confirm the clinical presentations. Objectives This study aimed to validate the use of power Doppler ultrasonography (PDUS) for evaluating synovial vascularity and synovial hypertrophy for synovitis in patients with rheumatoid arthritis (RA) treated with adalimumab. Methods The synovial disease activity and vascularity of RA on both wrists (radio-carpal joint) were assessed using GS and PDUS to derive the composite US scores based on abnormal counts and severity. The relationship between each measure was determined. Results The 71 patients who received adalimumab therapy had significantly decreased DAS28, ESR, and CRP. After one month, PD score decreased and then remained low for 12 months. Synovial hypertrophy did not change until 3–6 months after, when it started to improve ( p =0.017). By multivariate analysis, sex, age, BMI, and DAS28 did not lead to any difference between synovial hypertrophy and PDUS changes ( p =0.498). Conclusions Composite US markers of synovial hypertrophy correlate significantly to the DAS28 score and ESR/CRP in adult RA. The time needed for synovial hypertrophy to decrease may be up to 3–6 months after adalimumab therapy. Using ultrasound Doppler measurements predict success of treatment with anti-TNF-alpha has been a trend in monitoring biological therapy in patients with RA References Keystone EC, et al. Arthritis and rheumatism. May 2004;50(5):1400–1411. Disclosure of Interest None declared

Background Studies using ultrasound (US) showed that a significant proportion of patients thought to be in clinical remission actually exhibited different grades of synovitis, and a subgroup of these patients suffered from flares and/or joint damage during follow-up 1 . Objectives Evaluate joint inflammation by ultrasound in patients with different stages of rheumatoid arthritis as the primary endpoint measure. Methods Gray scale and power Doppler ultrasound were performed on the dorsal radio-scaphoid, dorsal radio-lunae, ulnar-triquetrium, and palmar radio-lunate joints of both wrists. The presence of synovitis, comorbidities, and use of disease modifying anti-rheumatic drugs were recorded. Patient with a bilateral wrist score sum (GSUS + PDUS) equal or greater than 4 was considered to have sonographic inflammation. A logistical regression model was used to identify factors associated with inflammation. Results There were 1248 patients (1010 females, 238 males; mean age: 59.61 ± 12.19 years). Synovitis was most common at the dorsal radio-lunate joint. Patients with high disease activity (DAS28 >5.1) had more sonographic inflammation than those with moderate or low disease activity. Most patients (57.4%) in complete remission (DAS28 Conclusions There was sonographic evidence of synovitis in most patients who were in complete remission. Regular monitoring of rheumatoid arthritis patients with ultrasound and DAS28 may help prevent disease flare-ups and joint destruction. References Brown AK, et al. Arthritis and Rheumatism 2006;54:3761–3773. Disclosure of Interest None declared

A fluctuating blood glucose level is one of the risks of chronic complications in diabetes. Previous studies indicated that hemoglobin A1c (HbA1c) values apparently improved after initiation of self-monitoring blood glucose (SMBG). The purpose of this study is to investigate the relationship between the frequency of SMBG, long-term fluctuatation of HbA1c, and risks of chronic complications in diabetes.We enrolled 1052 patients with type 2 diabetes. The mean follow-up was 4.7 years. The HbA1c level and frequency of SMBG were recorded every 3 months. Non-mydriatic retinal photography, semiquantitative neuropathy assessment, the lipid profile, serum creatinine level, and urine protein were measured at the beginning of the study and then every year. The fluctuation in HbA1c throughout the period was expressed as the standard deviations (SDs) of all measurements of the HbA1c.The frequency of SMBG was significantly and negatively correlated with the SDs of the HbA1c (r = -0.553, p0.001) but not with the average HbA1c. After controlling for age, sex, body mass index, duration of diabetes and comorbidities (dyslipidemia and hypertension), the correlation was still apparent (r = -0.511, p = 0.008). Patients with progression of nephropathy, neuropathy, and retinopathy, exhibited greater fluctuation of HbA1cs (2.38 ± 0.99 vs. 0.93 ± 1.16, p-value 0.002; 0.97 ± 1.59 vs. 0.90 ± 0.56, p-value 0.04; 0.99 ± 1.33 vs. 0.90 ± 0.56, p-value 0.04, respectively) and less frequent SMBG (3.2 ± 2.6 vs. 4.3 ± 3.1, p-value 0.02; 3.2 ± 2.6 vs. 4.1 ± 3.9, p-value 0.05; 3.0 ± 3.1 vs. 4.2 ± 2.8, p-value 0.01, respectively) than patients without progression of these complications.This study shows that frequent SMBG decreased the fluctuation of HbA1c and decreased microvascular complications. Decreasing fluctuation of HbA1c may play an important role in diabetes treatment.

The aim of this study was to identify the prognostic factors of long-term survival and optimal therapeutic protocol for patients with distant metastasis secondary to differentiated thyroid carcinoma (DTC). A retrospective review of 1665 patients with DTC treated at a regional tertiary hospital in Taiwan between 1986 and 2010 was performed. Among them, 207 patients were found to have distant metastasis. For a long-term outcome survey, 126 patients that had received at least 5 years (mean 9·6 ± 5·2 years) of follow-up after the diagnosis of distant metastasis were analysed for this study. Prognostic factor analysis included age, sex, histology, disease stage, type of surgical procedure, site of metastatic foci, (131) I avidity of tumour, thyroglobulin (Tg) level and accumulated therapeutic dose of radioiodine (RAI). The mean age at diagnosis of distant metastasis was 46·4 ± 17·2 years. The female-to-male ratio was 2·1:1. The 10- and 15-year survival rates were 70·6% and 64·9%, respectively. The independent predictors of survival were younger age, surgical dissection of neck lymph nodes (LNs) and low TSH-stimulated Tg level (400 μg/l) at the discovery of metastasis. Most cases of resolved (131) I-avid disease (79·2%) and disease-free remission (87·5%) received a cumulative dose no600 mCi of (131) I. The mean cumulative doses of (131) I in both deceased and living patients were similar. The prognosis of patients with distant metastasis from DTC within this study was found to be favourable. Survival may be improved by surgical dissection of neck LNs, but repeated (131) I therapy600 mCi is not advised unless there is a high probability that it would benefit the patient.

Elevations in blood pressure and visit-to-visit variability have been found to significantly increase the risk of cardiovascular morbidity and mortality in nondiabetic individuals. This study has assessed the association between all-cause mortality and blood pressure parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP) and visit-to-visit variability] in patients with type 2 diabetes.A longitudinal cohort study of 2161 patients with type 2 diabetes and a mean follow-up period of 66·7 ± 7·5 months. Using Cox regression models, blood pressure parameters were related to the risk of all-cause mortality.Visit-to-visit variability in SBP [HR: 1·048 (95% CI: 1·005-1·092; P = 0·03)], DBP [HR: 1·090 (95% CI: 1·021-1·163; P = 0·01)] and MAP [HR: 1·099 (95% CI: 1·033-1·170; P = 0·003)] significantly predicted all-cause mortality in patients with type 2 diabetes after adjusting for baseline data, mean follow-up blood pressure profiles and HbA1c. Visit-to-visit variability in PP [HR: 1·139 (95% CI: 1·030-1·258; P = 0·01)] significantly predicted cardiovascular mortality. Neither baseline nor follow-up SBP, DBP, PP nor MAP was significantly associated with all-cause and cardiovascular mortality after adjusting for blood pressure variability. The risk of all-cause mortality with a mean follow-up SBP has a U-shaped distribution. Patients with a mean follow-up DBP90 mmHg were at higher risk of mortality than those with DBP90 mmHg.Visit-to-visit variability in blood pressure was significantly associated with all-cause mortality independent of mean BP in patients with type 2 diabetes. The data for blood pressure variability might be regarded as a potentially important therapeutic target in the management of type 2 diabetes.

Background No study to date has evaluated whether multifactorial intervention can prevent diabetic nephropathy in patients with type 2 diabetes mellitus and normoalbuminuria. We evaluated the effect of tightly controlling multiple factors recommended by the American Diabetes Association (ADA) on the development and prevention of diabetic nephropathy in Chinese patients with type 2 diabetes mellitus and normoalbuminuria during a 4½-year period. Methods A longitudinal cohort study enrolled 1290 patients with type 2 diabetes and normoalbuminuria who received intensified treatment to meet the following ADA recommended goals: hemoglobin A 1c (HbA 1c ), less than 7%; systolic blood pressure, less than 130 mm Hg; diastolic blood pressure, less than 80 mm Hg; low-density lipoprotein cholesterol, less than 100 mg/dL; triglycerides, less than 150 mg/dL; and high-density lipoprotein cholesterol, greater than 40 mg/dL for men and greater than 50 mg/dL for women. Results During the study period, 211 patients (16.4%) developed new-onset microalbuminuria. A significant association was found between the achievement of ADA goals, including HbA 1c level less than 7% (hazard ratio [HR], 0.729; 95% confidence interval [CI], 0.553-0.906; P = .03), systolic blood pressure less than 130 mm Hg (0.645; 0.491-0.848; P = .002), and high-density lipoprotein cholesterol level greater than 50 mg/dL for women and greater than 40 mg/dL for men (0.715; 0.537-0.951; P = .02) and the development of new-onset microalbuminuria. Conclusions Diabetic nephropathy can be delayed by tight simultaneous achievement of multiple ADA-recommended targets. This multifactorial intervention should be started in patients with diabetes and normoalbuminuria.

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p0.01) and QCT (5.7%, p0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p0.0001), total hip (10.8%, p0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p0.0001).Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.

Background Vitamin D is essential for Ca absorption, prevention of falls and fracture, and maintenance of muscle strength and balance. Lack of awareness of the importance of vitamin D in bone health is common in Asia. Objective To define key statements, objectives and actions for improving osteoporosis management and vitamin D inadequacy in Asia. Results and conclusion This declaration was jointly produced by specialists at the Asia Metaforum on the Role of Vitamin D and the Management of Osteoporosis, held in September 2006 in Hong Kong, to define actions to prevent vitamin D insufficiency in Asia. Although developed specifically for Asia, some or all of these statements may be applicable to other regions of the world.

To investigate the significance of fatty liver as predictor of insulin resistance (IR) and chronic inflammation.This cross-sectional study included 450 adults of Han Chinese origin agedor=35. Excluded were cases with hepatitis B or C, alcoholic liver disease, or currently using thiazolidinedione. The volunteers were screened for the presence of the components of metabolic syndrome (MtS). IR index was estimated by the homeostasis model assessment. The fatty liver index was evaluated by computed tomography, calculated as the liver/spleen (L/S) ratio arrived at by averaging Hounsfield values obtained for five 3-mm slices. Serum levels of adiponectin, C-reactive protein (CRP), leptin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were checked in 100 subjects with low-L/S ratio and 100 age- and sex-matched controls.Fatty liver index correlated with all MtS traits and IR index. The values of L/S ratios in subjects with 0, 1, 2, 3 andor=4 traits of MtS were 1.25+/-0.13, 1.18+/-0.16, 1.12+/-0.21, 1.05+/-0.25 and 0.92+/-0.25, respectively (p0.001). In our stepwise regression analysis to compare the L/S ratios to the conventional traits of MtS for association with adipokine dysregulation, we found L/S ratio to be independently associated with most of them: adiponectin (p0.001), CRP (p0.001), IL-6 (p=0.005) and TNF-alpha (p=0.014).In Chinese, fatty liver index correlated well with IR index and can be a better marker of chronic inflammation than the conventional components of MtS.

Objective: A common variant in mitochondrial DNA (mtDNA) at bp 16189 (T→C transition) has been associated with small birth size, adulthood hyperglycemia, and insulin resistance in Caucasians. In this study, we investigated whether mtDNA 16189 variant is associated with metabolic syndrome in Chinese subjects. Methods: Six hundred fifteen Chinese adults, aged 40 yr or older, were recruited in this study. The 16189 variant of mtDNA was detected using PCR and restriction enzyme digestion. Metabolic syndrome was diagnosed on modified National Cholesterol Education Program Adult Treatment Panel III guidelines, using body mass index (BMI) instead of waist circumference. An association study was performed with χ2 test and logistic regression analysis. Results: The prevalence of the 16189 variant was higher in patients with metabolic syndrome than in those without: 44% (125 of 284) vs. 33.2% (110 of 331) (P = 0.006). The association between this 16189 variant of mtDNA and metabolic syndrome (P = 0.021) remained significant even after correcting for age and BMI. As to the individual traits, the prevalence of fasting plasma glucose of at least 110 mg/dl (≥6.1 mmol/liter) [(51.5% (121 of 235) vs. 42.1% (160 of 380); P = 0.023], type 2 diabetes mellitus [48.1% (113 of 235) vs. 39.2% (149 of 380); P = 0.031], and hypertriglyceridemia [44.3% (104 of 235) vs. 35.8% (136 of 380); P = 0.037] were significantly higher in subjects harboring the 16189 variant of mtDNA than those with the wild type. However, the prevalence of hypertension [53.2% (125 of 235) vs. 47.6% (181 of 380); P = 0.180], BMI greater than 25 kg/m2 [48.5% (114 of 235) vs. 43.9% (167 of 380); P = 0.270], and low high-density lipoprotein cholesterol [61.3% (144 of 235) vs. 54.7% (208 of 380); P = 0.111] did not reach a significant difference between the two groups. Furthermore, there was a trend of increasing frequency of occurrence of the 16189 variant in individuals having an increasing number of components of metabolic syndrome (Ptrend < 0.005). Conclusion: Our data strongly suggest that mtDNA 16189 variant underlies susceptibility to metabolic syndrome in the Chinese population.

A maximum likelihood sequence estimation (MLSE) and a maximum a posteriori (MAP) detector for DS-CDMA are proposed. The proposed receivers are attractive when the desired signal is in multi-code reception scenarios and when propagation channels are dispersive. Multipath results in loss of orthogonality among own-cell signals in the downlink and among same-user signals in the uplink. In these cases, receiver performance is limited by self-interference from the desired signal itself and interference from all other signals. The generalized RAKE (C-RAKE) receiver can be used to suppress both forms of interference, treating them as colored noise. To improve receiver performance further, we use an MLSE or a MAP detector to alleviate self-interference. The MAP detector can be used with the outer code decoder to form a turbo equalizer to further improve the receiver performance. Our numerical results show that gains larger than 2 dB over G-RAKE can be achieved by the proposed receivers for a WCDMA radio-access bearer of 4.6 Mbps using a 64-state sequence detector.

Publisher Summary The chapter focuses on lipid profiles in depression, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very-low density lipoprotein (VLDL) cholesterol, and the ratios of TC/HDL and LDL/HDL (atherogenic index). Most of the data that examined depressive symptoms and lipid profile levels have been from the community studies performed in different countries by the self-related depression scales. Most of these studies were performed by psychiatrists according to specific clinical criteria in psychiatric inpatients or outpatients, or in patients admitted for general health screening. Because depression is a major factor in most suicides, investigating the association between low serum-cholesterol levels and suicide may be important. There are many interactions among stress, lipid profiles, cortisone/HPA axis, and inflammation/immunity. In addition to lipid profiles and depression, one must investigate the relationships among lipid profiles and stress, cortisone/HPA axis, and inflammation/immunity. Some biological markers in cardiovascular disease are also used in the study of renal disease and diabetes, and could similarly be applied to the study of major depression. In addition, the influence of antipsychotics and antidepressants on the human body should be considered. Identifying the important links among physical illness, depression, and biological markers will be very important in the future, as many diseases have overlapping pathophysiology aspects. Perhaps better methods will be developed to help resolve these diffcult problems. However, the exact relationships among lipid metabolisms, HPA axis, immune abnormalities in major depression, and medical illness are still unknown.

We present a computationally efficient soft-output equalizer for communication over dispersive channels. The proposed equalizer has a forward and backward recursion structure similar to the classic BCJR MAP algorithm, but its complexity is reduced by constructing a reduced-state trellis, as in the decision feedback sequence estimator (DFSE). We are able to achieve consistent state definitions by running the backward pass on the same trellis as the forward pass. The performance of this reduced-complexity equalizer is evaluated within an iterative receiver in which the intersymbol interference (ISI) channel and channel code are treated as serially concatenated codes. The EDGE air interface is used as an illustrative example, for which we are able to reduce the number of states from 4096 to 8.

Leptin, a recently discovered protein produced in adipocytes, regulates body weight by suppressing food intake and/or increasing energy expenditure. Thyroid hormones, which increase the basal metabolic rate and thermogenesis, have been reported to be one of leptin's regulating factors because alternations in thyroid status might lead to compensatory changes in circulating leptin.The aim of this study was to assess the influence of sequential changes in thyroid function on serum leptin levels.The thyroid function status of 65 patients (55 women and 10 men, aged 40.6 +/- 15.2 years, mean +/- SD) with differentiated thyroid cancer who had received near-total thyroidectomy was studied before I-131 ablation therapy and after 2-4 and 6 months of levo-thyroxine suppressive therapy. Thirty-three (26 women, seven men; aged 41.0 +/- 10.4 years, mean +/- SD) of them were found to have become hypothyroid, then euthyroid and subsequently subclinically hyperthyroid. Their body mass index (BMI), body fat (%BF) by electrical bioimpedance, thyroid function and fasting serum leptin in these states were assessed and compared to those of 38 controls (30 women, eight men, aged 40.2 +/- 11.3 years, mean +/- SD). The controls had no past history or family history of thyroid diseases, and had the same range of BMI, between 20 and 30 kg/m2, as the patients.No difference in serum leptin levels was found between patients and controls with comparable age, sex, and BMI distribution in the euthyroid state. Using a repeated measures anova, tests of TSH, free T4 (FT4), BMI,%BF and leptin were performed on the 33 patients with sex as a grouping factor and thyroid state as a time factor. The sex difference for %BF and leptin proved to be statistically significant (P0.0001, and P = 0.0003, respectively). Serum leptin levels increased significantly from the hypothyroid to the subclinical hyperthyroid state (P0.0001) with a more pronounced increase found in females than in males (P = 0.03). Change of BMI during sequential thyroid function alterations was significant (P = 0.04) while change in %BF was not significant (P = 0.09). Pearson correlation analysis showed that serum leptin levels significantly correlated with BMI, %BF, FT4, and TSH (all P0.05). Using the generalized estimating equations, multivariate regression analysis revealed that FT4 was a statistically independent predictor for serum leptin (P0.0001). While other parameters were held constant, the mean serum leptin level increased by 1.47 units when serum FT4 was increased by one unit.In conclusion, our data indicate that circulating thyroid hormone plays a relevant role in regulating leptin metabolism independent of BMI and body fat.

As transforming growth factor-beta1 (TGF-beta1) is implicated in the pathogenesis of glomerulosclerosis, the aim of the study was to demonstrate if levels of glomerular TGF-beta1 mRNA in renal biopsies correlated with glomerulosclerosis. Glomeruli were collected by microdissection from renal biopsies in patients with membranous nephropathy, lupus nephritis, diabetic nephropathy, minimal change disease and IgA nephropathy presented by proteinuria when serum creatinine was3 mg%. Glomerular mRNAs were reverse transcribed and TGF-beta1, alpha2(IV) collagen, beta-actin cDNA quantitated by competitive polymerase chain reaction (PCR). By semiquantitative electron microscopy, a 3.5-fold increase of glomerular TGF-beta1/beta-actin mRNA ratio in the moderate sclerotic group (n = 23, p0.01) and a 1.5-fold increase in the mild sclerotic group (n = 22, p0.05) were observed when compared to the minimal sclerotic group (n = 12). A concordant increase of glomerular alpha2(IV) collagen mRNA was found with 2.2- and 1.3-fold in moderate and mild sclerotic groups, respectively. The TGF-beta1/beta-actin mRNA ratios were highest in membranous nephropathy (466.4 +/- 133.4, n = 11), followed by lupus nephritis (394.9 +/- 94.8, n = 12) and diabetic nephropathy (333.2 +/- 97.6, n = 10). Patients with minimal change disease(233.1 +/- 54.1, n = 15)and IgA nephropathy(185.3 +/- 39.6, n = 9) had low levels. The degree of glomerulosclerosis in each group followed the TGF-beta1/beta-actin mRNA ratios indicating that the level is the major determinant ofglomerulosclerosis but not the disease entities. Glomerular TGF-beta1/beta-actin mRNA ratio did not correlate with clinical parameters such as the urinary protein excretion and creatinine clearance. These results suggest that glomerular TGF-beta1/beta-actin mRNA ratio may be used as a marker of glomerulosclerosis in renal biopsy to reflect the local sclerotic process.

Background Vitamin D is essential for calcium metabolism, Vitamin D deficiency can precipitate osteoporosis, cause muscle weakness and increase the risk of fracture. The aim of this study was to assess the prevalence of vitamin D inadequacy among non-supplemented postmenopausal women with osteoporosis and fragility fractures of the hip or vertebrae in Taiwan. Methods This multi-center, cross-sectional, observational study analyzed the vitamin D inadequacy [defined as 25(OH) D level less than 30 ng/mL] in Taiwanese postmenopausal osteoporotic patients who suffered from a low trauma, non-pathological fragility hip or vertebral fracture that received post-fracture medical care when admitted to hospital or at an outpatient clinic. Results A total of 199 patients were enrolled at 8 medical centers in Taiwan; 194 patients met the study criteria with 113 (58.2%) and 81 (41.8%) patients diagnosed with hip and vertebral fracture, respectively. The mean serum 25(OH) D level was 21.1 ± 9.3 ng/mL, resulting in a prevalence of vitamin D inadequacy of 86.6% of the patients. Conclusions High prevalence of vitamin D inadequacy across all age groups was found among non-supplemented women with osteoporosis and fragility hip or vertebral fracture in Taiwan.