PREVALENCE OF VITAMIN DEFICIENCY IN ELDERLY PATIENTS PLANNED FOR SPINE SURGERY

2021 ◽  
pp. 1193-1199
Author(s):  
И. А. Степанов ◽  
В. А. Белобородов ◽  
М. А. Шамеева ◽  
И. И. Томашов ◽  
З. С. Саакян ◽  
...  
Keyword(s):  
Vitamin D ◽  
Elderly Patients ◽  
Vitamin D Deficiency ◽  
Surgical Procedures ◽  
Active Form ◽  
Binary Logistic Regression ◽  
Mineral Density ◽  
Binary Logistic Regression Model ◽  
Surgical Interventions

Снижение минеральной плотности костной ткани выступает наиболее частной причиной формирования осложнений в отдаленном периоде послеоперационного наблюдения. Цель исследования - изучить распространенность дефицита витамина D у пациентов пожилого возраста, планируемых к выполнению оперативных вмешательств на позвоночнике. В исследование включены 63 пациента пожилого возраста, госпитализированных в спинальные хирургические клиники для планового оперативного вмешательства по поводу дегенеративных заболеваний шейного и пояснично-крестцового отделов позвоночника (34 женщины, 29 мужчин, средний возраст - 63,6±3,2 года). Построение модели бинарной логистической регрессии показало, что достоверно ассоциированы с наличием дефицита активной формы витамина D у пациентов, планируемых к выполнению оперативных вмешательств на позвоночнике, следующие параметры: мужской пол, возраст (старше 65 лет), ИМТ (>30 кг/м) и сахарный диабет. Определение факторов риска, ассоциированных с наличием дефицита витамина D , и исследование маркеров костного метаболизма представляют собой важнейший этап предоперационной подготовки пациентов старшей возрастной группы, планируемых к выполнению оперативных вмешательств на позвоночнике. A decrease in bone mineral density is the most common cause of complications in the long-term period of postoperative observation. The purpose of the study was to study the prevalence of vitamin D deficiency in elderly patients who are planning to perform spine surgical procedures. The study included 63 elderly patients hospitalized in spine surgical clinics in order to perform planned surgical procedures for degenerative diseases of the cervical and lumbar spine (34 women, 29 men, average age 63,6±3,2 years). The construction of a binary logistic regression model showed that the following parameters are reliably associated with a deficiency of the active form of vitamin D in patients who are planning to perform surgical interventions on the spine: male gender, age (over 65 years), body mass index (more than 30 kg/ m) and diabetes. The identification of risk factors associated with the presence of vitamin D deficiency and the study of markers of bone metabolism represent the most important stage in the preoperative preparation of older patients who are planning to perform surgical interventions on the spine.

scholarly journals P1621VITAMIN D SUPPLEMENTATION: CHANGES IN BONE MINERAL DENSITY IN KIDNEY TRANSPLANT PATIENTS WITH LONG TERM DURATION OF THE GRAFT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yuri Battaglia ◽  
Michele Provenzano ◽  
Francesco Tondolo ◽  
Antonio Bellasi ◽  
Pasquale Esposito ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Kidney Transplant ◽  
Bone Mineral ◽  
Categorical Variables ◽  
Z Score ◽  
Mineral Density ◽  
T Score

Abstract Background and Aims In the medical literature, several studies have linked bone mineral density (BMD) with vitamin D deficiency in kidney transplant patients (KTRs). However, in spite of the fact that ergocalciferol, cholecalciferol and calcifediol reduce parathyroid hormone (PTH) and improves calcium levels, their effects on the bone mineral density (BMD) in KTRs remain undefined. In consideration of the lack of data available, we aim at investigating the effect of inactive form of vitamin D supplementation on the BMD over a follow-up period up to 2 year, in a real-life cohort of long-term kidney transplant(KT). Method This study was carried out in KTRs who were followed up in a Nephrology Unit. Exclusion criteria were parathyroidectomy, therapy with bisphosphonate, previous history of bone fractures. Demographic, clinical and immunosuppressive agents were collected. Based on 25-OH-D levels, KTRs were classified as suffering from deficiency (< 30 ng/mL). BMD was evaluated at lumbar vertebral bodies (LV) and right femoral hip (FH) by a single operator, using a standard dual energy X-ray absorptiometry. According to WHO criteria, results were expressed as T-score (standard deviation [SD] relative to young healthy adults), and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as T score ≤ −2.5 SD and T score < −1 and > −2.5 SD, respectively. Laboratory data, 25-OH-D, and BMD were measured at baseline and after 24 months of supplementation therapy. Vitamin D deficiency was corrected using standard treatment strategy recommended for general population. Continuous variables were expressed as mean ± SD whereas categorical variables as percentage. The Student’s t test and chi-square test were used to compare to compare continuous and categorical variables, respectively. For before and after comparisons of continuous variables, the paired t-test or one-sample Wilcoxon signed rank test were used based on variable’s distribution. Results Data pertaining to 111 out of 133 consecutive outpatients were collected, of whom most were males (69.4%), no-smokers (89.1%) and treated with glucocorticoids (84%). The mean age was 53.9±11.6 years and months after transplant was 161.6±128.3. No statistical differences were found among patients with normal BMD, osteopenia or osteoporosis at LV and FH in terms of age at transplant, gender distribution, time on dialysis, BMI and eGFR, serum calcium, serum phosphate, 25-OH-D and iPTH. At baseline, 25-OH-D was 13.9±7.2 ng/ml and the prevalence of osteopenia/osteoporosis was 40.9% (T-Score -1.69±0.37; Z-score -1.16±1.09) and 21.8 % (T-Score -3.15±0.50; Z-score -2.27±0.58) at LV; 55.3 % (T-Score -1.8±0.46; Z-score -0.84±0.633) and 14 % (T-Score -2.83±0.39; Z-score -1.65±0.49) at FH. After 27.6±3.7 months of therapy with cholecalciferol at mean dose of 13.396±7.537 UI at week, 25-OH-D values increased to 29.4±9.4 ng/ml (p<0.0001) while no statistically significant changes were found in Z-score and T-score at both sites, except for a mild improvement in lumbar vertebral Z-score, reaching −0.82± 0.7 (p = 0.06) in KTRs with osteopenia Conclusion Our study showed BMD remained stable after up to 2 years of inactive vitamin D therapy in long-term kidney transplant with vitamin D deficiency. A mild increase in Z-score was observed in the L-spine. Further designated studies should be conducted to demonstrate the effect of vitamin D on BMD.

Bone loss and vitamin D deficiency post gastrectomy for gastro-esophageal malignancy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 165-165 ◽  
Author(s):  
Kiran Virik ◽  
Robert Wilson
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Disease ◽  
Bone Health ◽  
Nutritional Supplementation ◽  
Type I ◽  
Mineral Density ◽  
Post Surgery

165 Background: Metabolic bone disease is a known but incompletely understood consequence of gastrectomy. Post gastrectomy osteoporosis (OP) is multifactorial. Evidence suggests that patients who undergo this surgery require long term bone health assessment and nutritional support. Methods: 30 post gastrectomy patients (2000-2008) from a single centre in Australia were evaluated re bone health post surgery and post nutritional supplementation. Exploratory analysis included: age, gender, pathology, type of surgery, 25 OH-vitamin D, calcium, parathyroid hormone (PTH), bone mineral density (BMD), vertebral XRs, urinary calcium and N telopeptides of type I collagen. Other risk factors evaluated were: smoking, corticosteroid use, alcohol intake, hyperthyroidism, menopausal status, hyperparathyroidism (hPTH), pre-existing bone disease. Results: The median age of the cohort was 67.5 (range 53-83) of whom 22 (73%) were male. Histology showed 16 (53%) gastric adenocarcinoma, 6 (20%) esophageal adenocarcinoma, 2 (7%) GISTs, 5 (17%) gastric/duodenal lymphoma and 1 other category. Similar numbers of patients underwent total (12) and partial/distal gastrectomy (12), with 6 having a subtotal gastrectomy. 22 (73%) had a Roux-en-Y or BR II reconstruction and 8 had a BRI/other. Median time from surgery to first BMD was 54.5 months (range 12-360) with median correlative calcium level 2.24 (range 1.97-2.49), median vitamin D level 43 (range 11-82) and median PTH 6.4 (range 1.8-13.8). Osteoporosis was diagnosed in 14 (47%) of patients, osteopenia in 14 and 2 (7%) patients had a normal BMD. Low vitamin D was seen in 23 (77%) patients, low calcium levels in 5 (17%) and secondary hPTH in 12 (41%). Post nutritional supplementation preliminary results showed 2/23 (9%) had a low vitamin D level, 3/11 (27%) had secondary hPTH, 5/19 (26%) had osteoporosis, 12/19 (63%) had osteopenia and 2/19 had a normal BMD. Analysis of other risk factors is to follow. Conclusions: Poor bone health and vitamin D deficiency is a clinically significant problem post gastrectomy. Patients should undergo long term nutritional and bone health surveillance in addition to their oncological follow up post resection.

Should Long-term Care Residents Be Supplemented with Vitamin D?

2008 ◽  
Vol 69 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Tracy Lister
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Older People ◽  
Vitamin D Deficiency ◽  
Long Term Care ◽  
Active Form ◽  
The United States ◽  
Sufficient Evidence ◽  
Term Care

The Health Canada recommendation of 600 IU of vitamin D daily for those over age 70 may be inadequate to prevent deficiencies. A literature search was conducted to examine whether older people living in long-term care (LTC) facilities are at high risk for vitamin D deficiency and therefore should receive a minimum daily supplement of 800 IU. The search included the major databases; the search terms “elderly” and “vitamin D” were used. Articles primarily related to calcium were excluded. The results show that North American seniors generally consume a diet low in vitamin D and have limited sun exposure. The majority, particularly those living in LTC facilities, may have a vitamin D deficiency. Also contributing to deficiencies is an age-related decline in cutaneous production of vitamin D and altered metabolic processes responsible for converting vitamin D to its active form. In summary, research conducted in both Canada and the United States provides sufficient evidence to indicate that older people living in LTC facilities are at high risk for vitamin D deficiency and should receive a minimum daily supplement of 800 IU.

scholarly journals Is There Pandemic Vitamin D Deficiency in the Black Population? A Review of Evidence

2015 ◽  
Vol 9 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Ria S. Roberts ◽  
Fafa Huberta Koudoro ◽  
Mark S. Elliott ◽  
Zhiyong Han
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Active Form ◽  
Serum Vitamin ◽  
Black Population ◽  
Biologically Active ◽  
Total Serum ◽  
Vitamin D Status ◽  
Mineral Density ◽  
Serum Vitamin D

Although 1,25-dihydroxyvitamin D [1,25(OH)2D] is the biologically active form of vitamin D, measurement of the total serum 25-hydroxyvitamin D [25(OH)D] level is the gold standard used to define vitamin D status. Currently, it is widely accepted that serum 25 (OH) D levels below 20 ng/ml defines vitamin D deficiency. According to this definition, there appears to be pandemic vitamin D deficiency in the Black population. However, there is no evidence of higher-than-normal rates of common complications and symptomology of true vitamin D deficiency in the Black population. What is going on? We researched the MEDLINE databases to find studies, from 1967 to present, that directly compare between Blacks and Caucasians the following: serum vitamin D level, serum calcium level, serum parathyroid hormone level, bone mineral density and health, and non-skeletal risks associated with vitamin D deficiency. The available studies consistently show that Blacks tend to have serum 25(OH)D levels in the deficient range while their serum 1,25(OH)D level is similar to, if not even slightly higher than that of Caucasians, and that the serum Ca2+ level in Blacks is virtually identical to that in Caucasians. Therefore, it appears that the serum 25(OH)D level is not the best marker of vitamin D sufficiency or deficiency in Blacks. In the future, clinical evaluation of the vitamin D status in the Black population needs to consider other serum biomarkers such as 1,25(OH)2D and/or bioavailable 25(OH)D.

Influence of vitamin D deficiency on the bone mineral density in schoolchildren

2015 ◽  
Author(s):  
Vladyslav Povoroznyuk ◽  
Nataliya Balatska ◽  
Olga Tyazhka ◽  
Tetiana Budnik ◽  
Inga Kubey ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals Vitamin D Deficiency in Testicular Cancer Survivors: A Systematic Review

2021 ◽  
Vol 22 (10) ◽  
pp. 5145
Author(s):  
Giuseppe Schepisi ◽  
Caterina Gianni ◽  
Sara Bleve ◽  
Silvia De Padova ◽  
Cecilia Menna ◽  
...  
Keyword(s):  
Vitamin D ◽  
Testicular Cancer ◽  
Vitamin D Deficiency ◽  
Molecular Mechanisms ◽  
Hypovitaminosis D ◽  
Young Males ◽  
Report Data ◽  
Testicular Cancer Survivors ◽  
Patients Experience

Testicular cancer (TC) is the most frequent tumor in young males. In the vast majority of cases, it is a curable disease; therefore, very often patients experience a long survival, also due to their young age at diagnosis. In the last decades, the role of the vitamin D deficiency related to orchiectomy has become an increasingly debated topic. Indeed, vitamin D is essential in bone metabolism and many other metabolic pathways, so its deficiency could lead to various metabolic disorders especially in long-term TC survivors. In our article, we report data from studies that evaluated the incidence of hypovitaminosis D in TC survivors compared with cohorts of healthy peers and we discuss molecular mechanisms and clinical implications.

scholarly journals Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1626
Author(s):  
Catalina Ballestero-Fernández ◽  
Gregorio Varela-Moreiras ◽  
Natalia Úbeda ◽  
Elena Alonso-Aperte
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Celiac Disease ◽  
Vitamin E ◽  
Nutritional Status ◽  
Bone Mineral ◽  
Biochemical Parameters ◽  
Gluten Free ◽  
Mineral Density

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

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