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Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon

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Abstract

Purpose

The purpose of this observational study was to evaluate serum levels of 25-OH-D of elderly patients presenting with orthopaedic illness. Furthermore, we enquired about potential confounders and risk factors of hypovitaminosis D in comorbidities and daily medication of the elderly.

Methods

Vitamin D levels in 1,083 patients aged >70 years and admitted to an orthopaedic surgery department were measured. Univariate and multivariate analyses were used to assess risk factors for insufficient vitamin D levels.

Results

Overall, 86 % of patients had insufficient serum levels of 25-OH-D and >60 % were vitamin D deficient. Serum vitamin D levels were lower during winter and months with fewer sunshine hours. Patients presenting with obesity, hypertension and osteoporosis were more likely to have low vitamin D levels.

Conclusions

We found a high prevalence of hypovitaminosis D in elderly, nonhospitalized orthopaedic patients. Given the well-known effects of vitamin D on bone metabolism and muscle health, as well as its nonskeletal effects, vitamin D insufficiency may have a negative impact.

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References

  1. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  CAS  PubMed  Google Scholar 

  2. Annweiler C, Souberbielle JC, Schott AM, de Decker L, Berrut G, Beauchet O (2011) Vitamin D in the elderly: 5 points to remember. Geriatr Psychol Neuropsychiatr Vieil 9:259–267

    PubMed  Google Scholar 

  3. Mattila C, Knekt P, Mannisto S, Rissanen H, Laaksonen MA, Montonen J, Reunanen A (2007) Serum 25-hydroxyvitamin D concentration and subsequent risk of type 2 diabetes. Diabetes Care 30:2569–2570

    Article  CAS  PubMed  Google Scholar 

  4. Giovannucci E, Liu Y, Hollis BW, Rimm EB (2008) 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 168:1174–1180

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Menkes DB, Lancaster K, Grant M, Marsh RW, Dean P, du Toit SA (2012) Vitamin D status of psychiatric inpatients in New Zealand’s Waikato region. BMC Psychiatry 12:68

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Hewison M (2010) Vitamin D and the immune system: new perspectives on an old theme. Endocrinol Metab Clin N Am 39:365–379

    Article  CAS  Google Scholar 

  7. Ginde AA, Mansbach JM, Camargo CA Jr (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 169:384–390

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 91:1255–1260

    Article  CAS  PubMed  Google Scholar 

  9. Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U (2014) Is there an association between periprosthetic joint infection and low vitamin D levels? Int Orthop 38:1499–1504

    Article  PubMed  Google Scholar 

  10. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820

    Article  CAS  PubMed  Google Scholar 

  11. Maier GS, Jakob P, Horas K, Roth KE, Kurth AA, Maus U (2013) Vitamin D deficiency in orthopaedic patients: a single center analysis. Acta Orthop Belg 79:587–591

    PubMed  Google Scholar 

  12. Hirani V, Primatesta P (2005) Vitamin D concentrations among people aged 65 years and over living in private households and institutions in England: population survey. Age Ageing 34:485–491

    Article  PubMed  Google Scholar 

  13. Schilling S (2012) Epidemic vitamin D deficiency among patients in an elderly care rehabilitation facility. Dtsch Arztebl Int 109:33–38

    PubMed Central  PubMed  Google Scholar 

  14. Maier GS, Jakobs P, Roth KE, Kurth AA, Maus U (2013) Is there an epidemic vitamin d deficiency in german orthopaedic patients? Clin Orthop Relat Res 471:3029–3035

    Article  PubMed Central  PubMed  Google Scholar 

  15. Sutra Del Galy A, Bertrand M, Bigot F, Abraham P, Thomlinson R, Paccalin M et al (2009) Vitamin D insufficiency and acute care in geriatric inpatients. J Am Geriatr Soc 57:1721–1723

    Article  PubMed  Google Scholar 

  16. Beauchet O, Helard L, Montero-Odasso M, de Decker L, Berrut G, Annweiler C (2012) Hypovitaminosis D in geriatric inpatients: a marker of severity of chronic diseases. Aging Clin Exp Res 24:188–192

    CAS  PubMed  Google Scholar 

  17. Annweiler C, Pochic S, Fantino B, Legrand E, Bataille R, Montero-Odasso M et al (2010) Serum vitamin D concentration and short-term mortality among geriatric inpatients in acute care settings. Adv Ther 27:245–249

    Article  CAS  PubMed  Google Scholar 

  18. Beauchet O, Launay CP, Maunoury F, de Decker L, Fantino B, Annweiler C (2013) Association between vitamin D deficiency and long hospital stay in geriatric acute care unit: results from a pilot cohort study. Aging Clin Exp Res 25:107–109

    Article  PubMed  Google Scholar 

  19. Simon J, Leboff M, Wright J, Glowacki J (2002) Fractures in the elderly and vitamin D. J Nutr Health Aging 6:406–412

    CAS  PubMed  Google Scholar 

  20. LeBoff MS, Hawkes WG, Glowacki J, Yu-Yahiro J, Hurwitz S, Magaziner J (2008) Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 19:1283–1290

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Bruyere O, Slomian J, Beaudart C, Buckinx F, Cavalier E, Gillain S et al (2014) Prevalence of vitamin D inadequacy in European women aged over 80 years. Arch Gerontol Geriatr 59:78–82

    Article  CAS  PubMed  Google Scholar 

  22. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293:2257–2264

    Article  CAS  PubMed  Google Scholar 

  23. Annweiler C, Montero-Odasso M, Schott AM, Berrut G, Fantino B, Beauchet O (2010) Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects. J Neuroeng Rehabil 7:50

    Article  PubMed Central  PubMed  Google Scholar 

  24. Hamilton B (2010) Vitamin D and human skeletal muscle. Scand J Med Sci Sports 20:182–190

    PubMed Central  CAS  PubMed  Google Scholar 

  25. Soysal P, Yay A, Isik AT (2014) Does vitamin D deficiency increase orthostatic hypotension risk in the elderly patients? Arch Gerontol Geriatr 59:74–77

    Article  CAS  PubMed  Google Scholar 

  26. McCarroll KG, Robinson DJ, Coughlan A, Healy M, Kenny RA, Cunningham C (2012) Vitamin D and orthostatic hypotension. Age Ageing 41:810–813

    Article  PubMed  Google Scholar 

  27. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    Article  CAS  PubMed  Google Scholar 

  28. Drinka P (1996) Vitamin D deficiency in older people. J Am Geriatr Soc 44:333

    CAS  PubMed  Google Scholar 

  29. Rizzoli R, Boonen S, Brandi ml, Bruyere O, Cooper C, Kanis JA et al (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29:305–313

    Article  CAS  PubMed  Google Scholar 

  30. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY et al (2004) Effect of Vitamin D on falls: a meta-analysis. JAMA 291:1999–2006

    Article  CAS  PubMed  Google Scholar 

  31. Gerdhem P, Ringsberg KA, Obrant KJ, Akesson K (2005) Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Int 16:1425–1431

    Article  CAS  PubMed  Google Scholar 

  32. Di Monaco M, Vallero F, Castiglioni C, Di Monaco R, Tappero R (2011) Low levels of 25-hydroxyvitamin D are associated with the occurrence of concomitant upper limb fractures in older women who sustain a fall-related fracture of the hip. Maturitas 68:79–82

    Article  PubMed  Google Scholar 

  33. Brustad M, Edvardsen K, Wilsgaard T, Engelsen O, Aksnes L, Lund E (2007) Seasonality of UV-radiation and vitamin D status at 69 degrees north. Photochem Photobiol Sci 6:903–908

    Article  CAS  PubMed  Google Scholar 

  34. Wolpowitz D, Gilchrest BA (2006) The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol 54:301–317

    Article  PubMed  Google Scholar 

  35. Segal E, Zinman C, Raz B, Ish-Shalom S (2009) Low patient compliance–a major negative factor in achieving vitamin D adequacy in elderly hip fracture patients supplemented with 800 IU of vitamin D3 daily. Arch Gerontol Geriatr 49:364–367

    Article  CAS  PubMed  Google Scholar 

  36. de Boer IH, Ioannou GN, Kestenbaum B, Brunzell JD, Weiss NS (2007) 25-Hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis 50:69–77

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Trauma Surgery, Justus-Liebig-University, Giessen, Germany

    Gerrit Steffen Maier & Jörn Bengt Seeger

  2. Department of Orthopaedic Surgery, Johannes-Gutenberg-University, Mainz, Germany

    Klaus Edgar Roth

  3. Orthopaedic Specialty Center, Fachklinik Ratingen, Ratingen, Germany

    Andreas Alois Kurth

  4. ANZAC Research Institute, University of Sydney, Sydney, Australia

    Konstantin Horas

  5. University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany

    Uwe Maus

  6. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Str. 7, 35932, Gießen, Germany

    Gerrit Steffen Maier

Authors
  1. Gerrit Steffen Maier
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  2. Konstantin Horas
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  3. Jörn Bengt Seeger
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  4. Klaus Edgar Roth
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  5. Andreas Alois Kurth
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  6. Uwe Maus
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Correspondence to Gerrit Steffen Maier.

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Maier, G.S., Horas, K., Seeger, J.B. et al. Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon. International Orthopaedics (SICOT) 39, 787–792 (2015). https://doi.org/10.1007/s00264-014-2519-3

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  • DOI: https://doi.org/10.1007/s00264-014-2519-3

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