The Effects and Interactions of Vitamin D Deficiency, Calcium and Parathyroid Hormone on Physical Concerns in the Elderly: A Review

Background: Osteoporosis is a common age related problem especially in women, with a consequent increase in bone fragility and susceptibility to fracture. Apart from Calcium, another nutrient that plays an important role in the mineralization of skeleton in Vitamin D. Osteocalcin, which is produced primarily by osteoblasts during bone formation, is considered to be one of the markers for osteoporosis.Methods: 314 women above the age of 40 were included into the study. A thorough physical and clinical examination, assessment of vital parameters, anthropometry evaluation was done for all patients. Bone mineral density was calculated using central DXA osteodensitometer at lumbar spine L1-L4, hip and ultradistal radius (in some cases.). Blood samples were taken for the detection of ionized calcium, phosphorus, alkaline phosphatase, 25hydroxivitamin D (25 ODH) and serum parathyroid hormone (PTH) by chemiluminiscent assay. Bone markers such as osteocalcin were measured as required.Results: Out of the 314 women attending our OPD, 96 of them were diagnosed as having osteoporosis. 24 out of them had fragility fractures, mainly of the hip, and 82 had ostepenia. Elevated levels of calcium (8.96 mg/dl), parathyroid hormone (58.76 pg/ml) and osteocalcin (24.46 ng/ml) were observed. Vitamin D deficiency of ≤ 20 was seen in 59 (63%) of the cases, insufficient in 23 (24%) and only 12 (13%) of these women had normal Vitamin D levels.Conclusions: Osteocalcin is a promising marker for the detection of osteoporosis. There is a considerable Vitamin D deficiency among the women with osteoporosis, and it is under-treated. It is essential to provide Vitamin D supplementation to these women especially those who are at high risk for fragility fractures.

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No association between vitamin D deficiency and parathyroid hormone, bone density and bone turnover in a large cohort of HIV-infected men on tenofovir

Journal of the International AIDS Society ◽

10.7448/ias.17.4.19568 ◽

2014 ◽

Vol 17 ◽

pp. 19568 ◽

Cited By ~ 8

Author(s):

Amanda Samarawickrama ◽

Sophie Jose ◽

Caroline Sabin ◽

Karen Walker-Bone ◽

Martin Fisher ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Bone Density ◽

Bone Turnover ◽

Vitamin D Deficiency ◽

Large Cohort

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Parathyroid hormone (PTH)/PTH-related protein receptor messenger ribonucleic acid expression and PTH response in a rat model of secondary hyperparathyroidism associated with vitamin D deficiency.

Endocrinology ◽

10.1210/endo.136.9.7649081 ◽

1995 ◽

Vol 136 (9) ◽

pp. 3751-3758 ◽

Cited By ~ 22

Author(s):

G Turner ◽

C Coureau ◽

M R Rabin ◽

B Escoubet ◽

M Hruby ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Rat Model ◽

Ribonucleic Acid ◽

Related Protein ◽

Messenger Ribonucleic Acid ◽

Protein Receptor

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Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation

Blood ◽

10.1182/blood-2010-09-309708 ◽

2011 ◽

Vol 117 (10) ◽

pp. 2800-2806 ◽

Cited By ~ 69

Author(s):

Todd S. Perlstein ◽

Reena Pande ◽

Nancy Berliner ◽

Gary J. Vanasse

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Levels ◽

The Elderly ◽

Vitamin D Supplementation ◽

World Health ◽

Elderly Persons ◽

Increased Risk ◽

Health Organization ◽

Anemia Of Inflammation

AbstractAnemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We used the Third National Health and Nutrition Examination Survey to examine the association of vitamin D deficiency with anemia subtypes in persons aged ≥ 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL, and anemia was defined according to World Health Organization criteria. Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P = .02) and varied significantly by anemia subtype (P overall = .003). The prevalence of vitamin D deficiency was 33.3% in the nonanemic population, 56% in anemia of inflammation (AI; P = .008), and 33.0% in unexplained anemia (P = .55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency. These data show that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI. Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted.

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Does vitamin D deficiency increase orthostatic hypotension risk in the elderly patients?

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2014.03.008 ◽

2014 ◽

Vol 59 (1) ◽

pp. 74-77 ◽

Cited By ~ 27

Author(s):

Pinar Soysal ◽

Adnan Yay ◽

Ahmet Turan Isik

Keyword(s):

Vitamin D ◽

Elderly Patients ◽

Orthostatic Hypotension ◽

Vitamin D Deficiency ◽

The Elderly

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Nutrihealth Study: Seasonal Variation in Vitamin D Status Among the Slovenian Adult and Elderly Population

Nutrients ◽

10.3390/nu12061838 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1838 ◽

Cited By ~ 1

Author(s):

Maša Hribar ◽

Hristo Hristov ◽

Matej Gregorič ◽

Urška Blaznik ◽

Katja Zaletel ◽

...

Keyword(s):

Vitamin D ◽

Seasonal Variation ◽

Vitamin D Deficiency ◽

Elderly Population ◽

Sun Exposure ◽

Epidemiological Data ◽

The Elderly ◽

Vitamin D Insufficiency ◽

Ultraviolet B ◽

Vitamin D Status

Several studies conducted around the world showed substantial vitamin D insufficiency and deficiency among different population groups. Sources of vitamin D in the human body include ultraviolet B (UVB)-light-induced biosynthesis and dietary intake, but people’s diets are often poor in vitamin D. Furthermore, in many regions, sun exposure and the intensity of UVB irradiation during wintertime are not sufficient for vitamin D biosynthesis. In Slovenia, epidemiological data about vitamin D status in the population were investigated through a national Nutrihealth study—an extension to the national dietary survey SI.Menu (2017/18). The study was conducted on a representative sample of 125 adult (18–64 years) and 155 elderly (65–74 years old) subjects, enrolled in the study in different seasons. Their vitamin D status was determined by measuring the serum 25-hydroxy-vitamin D (25(OH)D) concentration. Thresholds for vitamin D deficiency and insufficiency were 25(OH)D levels below 30 and 50 nmol/L, respectively. Altogether, 24.9% of the adults and 23.5% of the elderly were found to be vitamin D deficient, while an insufficient status was found in 58.2% and 62.9%, respectively. A particularly concerning situation was observed during extended wintertime (November–April); vitamin D deficiency was found in 40.8% and 34.6%, and insufficient serum 25(OH)D levels were observed in 81.6% and 78.8%, respectively. The results of the study showed high seasonal variation in serum 25(OH)D levels in both the adult and elderly population, with deficiency being especially pronounced during wintertime. The prevalence of this deficiency in Slovenia is among the highest in Europe and poses a possible public health risk that needs to be addressed with appropriate recommendations and/or policy interventions.

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