A Descriptive Study on Vitamin D Levels in Individuals With Spinal Cord Injury in an Acute Inpatient Rehabilitation Setting

Nemunaitis, Gregory; Mejia, Melvin; Nagy, Jennifer; Johnson, Tova; Chae, John; Roach, Mary Joan

doi:10.1016/j.pmrj.2010.01.010

Cited by 48 publications

(53 citation statements)

References 32 publications

(57 reference statements)

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“…33 We detected significantly higher vitamin D levels in individuals with incomplete SCI (P < 0.01), which is in controversy with these studies. 32 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of bone mineral loss in patients with chronic traumatic spinal cord injury in Iran

Javidan

Sabour

Latifi

et al. 2014

The Journal of Spinal Cord Medicine

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Objectives: We described the associations between demographic and injury-related factors on bone mineral density (BMD) of the spine and the hip among adult patients with chronic spinal cord injury (SCI). Design: BMD in spinal and femoral bone sites were assessed. Multivariate analysis was performed to evaluate the relationship between anthropometric and injury-related factors with BMD. Serum level and amount of dietary intake of calcium, phosphor, and 25-hydroxy vitamin D were measured. Setting: A referral tertiary rehabilitation center in Iran. Participants: Patients with SCI who had no previous history of endocrine disorders and were not on specific medications entered the investigation. Those with non-traumatic SCI, pregnant, or with substance dependency were excluded as well. Interventions: No interventions were applied. Main study outcome measures: Dual X-ray absorptiometry was performed to estimate BMD. Body mass index was positively associated with higher femoral (P < 0.01, r = 0.56) and hip (P < 0.0001, r = 0.82) BMD only in female participants. The high prevalence of vitamin D deficiency (60%) was noticeable. Results: Older male patients revealed lower BMD only in spinal vertebrae (P < 0.02, r = −0.21). A significant higher BMD loss in lumbar vertebras in male patients with complete spinal cord lesion (P < 0.009) was detected. Spinal reduction of BMD was more severe when the level of injury was above T6 (P < 0.02). Conclusion: Along with the clarification of age, gender, post injury duration, and the other factors' effect on the BMD in the SCI patients, here we have also shown the noticeable prevalence of the 25-hydoxy vitamin D deficiency in these patients which needs attention.

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“…33 We detected significantly higher vitamin D levels in individuals with incomplete SCI (P < 0.01), which is in controversy with these studies. 32 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of bone mineral loss in patients with chronic traumatic spinal cord injury in Iran

Javidan

Sabour

Latifi

et al. 2014

The Journal of Spinal Cord Medicine

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show abstract

“…6,11,12 Because of multiple etiologies, vitamin D deficiency has been reported to be extremely prevalent in the SCI population, as well as in those with other disabilities. [1][2][3][4][5] Persons with SCI often have a lower calcium intake than the general population, including vitamin D-fortified milk, which is the major dietary source of vitamin D, excluding supplements. 13 Those with disability tend to have a much reduced sunlight exposure, and conversion of vitamin D precursors to the active form requires ultraviolet exposure.…”

Section: Discussionmentioning

confidence: 99%

“…1 Other investigators have confirmed and extended our original findings of a higher prevalence of vitamin D deficiency in persons with chronic SCI. [2][3][4][5] This study was performed to determine whether oral supplementation with 2000 IU vitamin D 3 and supplemental calcium for 3 months in persons with SCI who were vitamin D deficient is safe and a sufficient dosage to raise 25(OH)D levels to >30 ng/ml to improve calcium metabolism by suppressing parathyroid hormone and bone turnover. Hence, such an approach would be anticipated to reduce bone loss over the long term.…”

Section: Introductionmentioning

confidence: 99%

An effective oral vitamin D replacement therapy in persons with spinal cord injury

Bauman

Emmons

Cirnigliaro

et al. 2011

The Journal of Spinal Cord Medicine

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Background/objective: Vitamin D deficiency is prevalent in chronic spinal cord injury (SCI). A 3-month course of oral vitamin D 3 to 'normalize' serum vitamin D levels was investigated. Design: Prospective drug-intervention study. Setting: VA Medical Center; private rehabilitation facility. Methods: Seven individuals with chronic SCI and vitamin D deficiency completed 3 months of oral vitamin D 3 (i.e. cholecalciferol) supplementation. At screening, baseline, and months 1 and 3, blood was collected for serum calcium, 25 hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), and N-telopeptide (NTx); 24-hour urine for calcium, creatinine, and NTx was performed. Oral vitamin D 3 (2000 IU daily) and elemental calcium (1.3 g daily) were prescribed for 90 days. The results are expressed as mean ± standard deviation (SD). Analysis of variance with a Fisher's post-hoc analysis was performed to test for differences between study visits. Subjects were classified as deficient (<20 ng/ml), relatively deficient (20-30 ng/ml), or not deficient (>30 ng/ml) in 25(OH)D. Results: Serum 25(OH)D levels were greater at months 1 and 3 than at baseline (26 ± 6 and 48 ± 17 vs. 14 ± 2 ng/ml; P = 0.005). Six of seven subjects were no longer deficient [25(OH)D >30 ng/ml] by month 3. Serum iPTH levels were significantly decreased at month 1 and month 3; serum NTx levels were significantly lower at month 3 than at baseline. Serum and urinary calcium levels remained within the normal range. Conclusion: A daily prescription of 2000 IU of oral vitamin D 3 for 3 months safely raised serum 25(OH)D levels into the normal range in persons with chronic SCI on calcium supplementation.

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“…In addition to a negative-acting on bone tissue, hypovitaminosis D may impair other aspects such as muscle strength, and cause complications related to different organs [19]. According to a study by Nemunaitis et al [14], people with tetraplegia and those with pressure ulcer had severely decreased vitamin D values, with a mean below 10 ng/mL. In the comparison between serum levels of PTH and time of injury we can observe a tendency for a positive correlation, which might indicate that the longer the injury time, the higher levels of PTH were found, although this finding was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Individuals with SCI may have an inadequate or severely deficient level of vitamin D, which can result mainly in secondary hyperparathyroidism, decreased bone mineral density, osteoporosis and increased risk of fractures [13,14]. Secondary hyperparathyroidism and vitamin D deficiency also play an important role in the development of post SCI osteoporosis [13].…”

Section: Introductionmentioning

confidence: 99%

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

Bassuino¹,

Kaminski²,

Garcia³

et al. 2018

Sci Med

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A Descriptive Study on Vitamin D Levels in Individuals With Spinal Cord Injury in an Acute Inpatient Rehabilitation Setting

Abstract: Inadequate or severely deficient levels of VitD-25(OH) were highly prevalent in patients with SCI admitted to an acute inpatient rehabilitation service. Evaluation of serum VitD-25(OH) levels are recommended in patients with SCI because low levels may contribute to osteoporosis.

Cited by 48 publications

References 32 publications

Evaluation of bone mineral loss in patients with chronic traumatic spinal cord injury in Iran

Evaluation of bone mineral loss in patients with chronic traumatic spinal cord injury in Iran

An effective oral vitamin D replacement therapy in persons with spinal cord injury

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

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