Association of Serum Vitamin D and Calcium Levels With the Severity of Intertrochanteric Fractures in the Elderly: A Retrospective Study

2020 ◽  
Author(s):  
Seok-Min Hwang ◽  
Suk-Hyun Hwang ◽  
Yeon-Ho Kim

Abstract Background: Femur intertrochanteric fractures can be classified into stable and unstable fractures according to their severity. Postoperative complications and mortality were more common in patients with unstable intertrochanteric fractures. However, there has been little effort to evaluate the risk factors of the two fracture types. This study aimed to identify the possible differences in demographic and clinical characteristics of older patients with different types of intertrochanteric fractures.Methods: The medical records of patients aged ≥60 years who presented with intertrochanteric fractures from June 2018 to March 2020 were retrospectively reviewed. Fifty-seven patients were enrolled and divided into two groups according to severity: stable (21 patients) and unstable (36 patients). Demographic data, body mass index (BMI), ambulatory ability prior to fracture, pre-fracture residence, season at fracture, bone mineral density (BMD), and serum 25-hydroxyvitamin D [25(OH)D], osteocalcin, and calcium levels were compared between the two groups. Additionally, we analyzed the correlation among variables.Results: The stable group had significantly higher serum 25(OH)D and calcium levels than the unstable group (p = 0.010, p = 0.019). There were no statistically significant differences (p > 0.05) in age, sex, height, weight, BMI, ambulatory ability prior to fracture, pre-fracture residence, season at fracture, BMD, and serum osteocalcin level between the two groups. In addition, serum 25(OH)D and calcium levels were not correlated with any of the variables in all patients.Conclusion: Low vitamin D and calcium levels are associated with unstable intertrochanteric fracture in elderly patients. Maintaining adequate vitamin D and calcium levels could avoid an increase in the severity of intertrochanteric fractures.

2016 ◽  
Vol 26 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Laurel M. Wentz ◽  
Pei-Yang Liu ◽  
Jasminka Z. Ilich ◽  
Emily M. Haymes

Background:High rates of vitamin D deficiency have been reported in athletes. The purpose of this study was to evaluate the associations between vitamin D with bone health and parathyroid hormone (PTH) concentrations in female runners who trained at 30.4° degrees north.Methods:Serum 25-hydroxyvitamin D (25(OH) D), PTH, body composition, and bone mineral density (BMD) were measured in 59 female runners, aged 18–40 years. Stress fracture history, training duration and frequency were evaluated by questionnaire. As per National Endocrine Society cut-offs, serum vitamin D ranges were: 25(OH)D < 50 nmol/L for deficient; 50–75 nmol/L for insufficient; and ≥ 75 nmol/L for sufficient status.Results:Mean serum 25(OH)D concentrations were 122.6 ± 63.9 nmol/L, with 18.6% of subjects in the deficient (5.1%) or insufficient (13.5%) range. No significant differences were observed between sufficient and deficient/insufficient subjects for BMD, PTH, history of stress fractures, or demographic data.Conclusions:The majority of distance runners maintained sufficient vitamin D status, suggesting that training outdoors in latitude where vitamin D synthesis occurs year-round reduces the risk for vitamin D deficiency. Data do not support the indiscriminate supplementation of outdoor athletes in southern latitudes without prior screening.


2007 ◽  
Vol 77 (6) ◽  
pp. 376-381 ◽  
Author(s):  
de Souza Genaro ◽  
de Paiva Pereira ◽  
de Medeiros Pinheiro ◽  
Szejnfeld ◽  
Araújo Martini

Vitamin D is essential for maintaining calcium homeostasis and optimizing bone health. Its inadequacy is related to many factors including dietary intake. The aim of the present study was to evaluate serum 25(OH)D and its relationship with nutrient intakes in postmenopausal Brazilian women with osteoporosis. This cross-sectional study comprised 45 free-living and assisted elderly at São Paulo Hospital. Three-day dietary records were used to assess dietary intakes. Bone mineral density was measured with a dual-energy X-ray absorptiometer (DXA). Blood and urine sample were collected for analysis of biochemical markers of bone and mineral metabolism. Insufficiency of vitamin D was observed in 24.4% of the women and optimal levels (≥ 50 nmol/L) were observed in 75.6%. Parathyroid hormone was above the reference range in 51% of the participants. The mean calcium (724 mg/day) and vitamin D (4.2 μ g/day) intakes were lower than the value proposed by The Food and Nutrition Board and sodium intake was more than two-fold above the recommendation. Higher levels of serum 25(OH)D were inversely associated with sodium intake. Dietary strategies to improve serum vitamin D must focus on increasing vitamin D intake and should take a reduction of sodium intake into consideration.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1759.2-1759
Author(s):  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
O. Nikitinskaya ◽  
N. Demin ◽  
A. Smirnov ◽  
...  

Background:The onset of the disease in young and middle age is typical for rheumatic diseases (RDS), but most studies on osteoporosis were conducted in patients (pts) older than 50 years, which included postmenopausal women.Objectives:To assess bone mineral density (BMD), fracture frequency and the factors associated with low BMD in premenopausal women with RDs.Methods:160 women (median age, 36 [29; 43] years): 120 pts with RDs (43 rheumatoid arthritis (RA), 53 systemic sclerosis (SSc) and 24 psoriatic arthritis (PsA)) and 40 age-matched healthy controls were enrolled in the study. We performed a dual-energy X-ray absorptiometry (DXA, Hologic Discovery A, USA) to measure BMD in lumbar spine, femoral neck and total hip. BMD decreasing grade was evaluated by the Z-score <-2SD. All pts were interviewed using a unified questionnaire including assessment of daily dietary calcium intake. Serum vitamin D, C-reactive protein and erythrocyte sedimentation rate (ESR) measurements were done.Results:25% pts with RDs and only 8% healthy controls have low BMD (p=0.02). RA, SSc and PsA pts had low BMD in 37%, 21% and 13%, respectively, that was more often than in healthy women (p=0.004, p=0.046 and p= 0.081, respectively). 9,3% RA pts and 7,5% SSc pts had low energy fractures. BMD of RDs pts in all areas of measurement demonstrated a direct correlation with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. Also, proximal femur BMD inversely correlated with RDs duration. BMD of femoral neck and total hip inversely correlated with C-reactive protein level in SSc pts. In RA women we found a direct correlation between lumbar spine and femur neck BMD and ESR.Conclusion:25% of premenopausal women with RDs had reduced BMD and needed monitoring and osteoporosis prevention, while 9.3% pts with RA and 7.5% women with SSc needed anti-osteoporotic treatment.Disclosure of Interests:None declared


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Bankole Peter Kuti ◽  
Alex Ifeoluwa Akinwumi ◽  
Demilade Kehinde Kuti ◽  
Kazeem Olanrewaju Amoo

Abstract Background The pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties therefore hold prospects in the prevention and management of pneumonia in children. This case–control study set out to compare the serum 25-hydroxyvitamin D (25-OHD) and total antioxidant capacity (TAC) in Nigerian children with CAP and age- and sex-matched controls and to relate these parameters with pneumonia severity and outcome—length of hospital stay (LOH). Results A total of 160 children (80 each for CAP and controls) were recruited. The median (IQR) age was 1.8 (0.6–4.0) years, male:female 1.7:1, 63 (78.8%) and 11 (13.8%) of CAP group had severe pneumonia and parapneumonic effusions, respectively. Serum 25-OHD (33.8 (18.3) ng/ml vs. 41.9 (12.3) ng/ml; p = 0.010) and TAC (6.1 (4.4–8.1) ng/dl vs. 7.2 (4.7–17.5) ng/dl; p = 0.023) were lower in children with CAP than controls. Lower serum 25-OHD was observed in severe than non-severe pneumonia (30.5(17.1) ng/ml vs. 46.3 (17.6) ng/ml; p = 0.001) but LOH did not correlate with serum 25-OHD and TAC. Conclusion Children with CAP had lower serum vitamin D and antioxidants than controls, and severe pneumonia was significantly associated with suboptimal serum vitamin D. They however were not related to pneumonia outcome. Optimal serum vitamin D and antioxidants may play a role in reducing the incidence of childhood CAP in Nigerian children.


Author(s):  
Cora M Best ◽  
Leila R Zelnick ◽  
Kenneth E Thummel ◽  
Simon Hsu ◽  
Christine Limonte ◽  
...  

Abstract Context The effect of daily vitamin D supplementation on the serum concentration of vitamin D (the parent compound) may offer insight into vitamin D disposition. Objective To assess the total serum vitamin D response to vitamin D3 supplementation and whether it varies according to participant characteristics. To compare results with corresponding results for total serum 25-hydroxyvitamin D (25(OH)D), which is used clinically and measured in supplementation trials. Design Exploratory study within a randomized trial. Intervention 2,000 International Units of vitamin D3 per day (or matching placebo). Setting Community-based. Participants 161 adults (mean ± SD age 70 ± 6 years; 66% males) with type 2 diabetes. Main Outcome Measures Changes in total serum vitamin D and total serum 25(OH)D concentrations from baseline to year 2. Results At baseline, there was a positive, nonlinear relation between total serum vitamin D and total serum 25(OH)D concentrations. Adjusted effects of supplementation were a 29.2 (95% CI: 24.3, 34.1) nmol/L increase in serum vitamin D and a 33.4 (95% CI: 27.7, 39.2) nmol/L increase in serum 25(OH)D. Among those with baseline 25(OH)D &lt; 50 compared with ≥ 50 nmol/L, the serum vitamin D response to supplementation was attenuated (15.7 vs 31.2 nmol/L; interaction p-value = 0.02), whereas the serum 25(OH)D response was augmented (47.9 vs 30.7 nmol/L; interaction p-value = 0.05). Conclusions Vitamin D3 supplementation increases total serum vitamin D and 25(OH)D concentrations with variation according to baseline 25(OH)D, which suggests that 25-hydroxylation of vitamin D3 is more efficient when serum 25(OH)D concentration is low.


2020 ◽  
Vol 68 (2) ◽  
pp. 394 ◽  
Author(s):  
ErhanArif Ozturk ◽  
Ibrahim Gundogdu ◽  
Burak Tonuk ◽  
Ebru Umay ◽  
BilgeGonenli Kocer ◽  
...  

2019 ◽  
Vol 49 (4) ◽  
pp. 506-516 ◽  
Author(s):  
Shirani Ranasinghe ◽  
Thilak Jayalath ◽  
Sampath Thennakoon ◽  
Ranjith Jayasekara ◽  
Ran Shiva ◽  
...  

Purpose Purpose of this study is to measure the Vitamin D status of healthy adults and to correlate with their lifestyle and feeding habits. Plasma 25-Hydroxyvitamin D (25(OH)D) is the most common marker of vitamin D status of an individual. Deficiency of vitamin D is defined as the serum level less than 20 ng/mL and insufficiency as 30 ng/mL which can be prevented. Design/methodology/approach Vitamin D status of healthy adults (n = 82), both male and females between the age of 18 – 50 years who were attending to the National Transport Authority, Kandy, Sri Lanka from February to March 2016, was measured and correlated with their lifestyle, feeding habits, etc. Findings The mean total serum D (25(OH)D in this study was 40.15 ± 3.74 nmol/l with the mean value of 42.8 ± 28.8 and 37.5 ± 16.6 for women and men, respectively. The serum calcium levels of both female and male were around 8 mg/dl and the serum total protein was 6.5 and 7 g/dl in women and men, respectively. The serum Vitamin D, calcium and total protein were not statistically significantly different between the sexes. In this study, 84 per cent of the total subjects were normocalcemic, and there was no significant relationship between vitamin D levels and their calcium levels. Research limitations/implications This study demonstrates that there was no statistically significant correlation between the serum vitamin D with age, serum calcium or total proteins. The majority of participants who had exposure to the sunlight more than 30 mins/day had sufficient level of vitamin D and less than 30 min/day exposure had deficiency of vitamin D. Daily intake of multivitamin influenced vitamin D status of the study group. Practical implications These findings will implicate the importance of cultural, feed and social habits for the nutritional status of an individual.and there are no reported studies on vitamin D status with reference to the variation of life style. Social implications It is very important to investigate the factors affecting to the vitamin D status of a population as such, vitamin D insufficiency or deficiency can be prevented. In Sri Lanka, the population is consisting with many ethnic groups, different ethnic groups may find some nutritional problems according to their main cultural habits. Originality/value The objectives of this study are to evaluate the Vitamin D status in a group of healthy adults between 20 and 50 years in both men and women and to find out the correlation of their vitamin D status with their lifestyle and feeding habits, etc.


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