Assessment of vitamin D and calcium status in healthy adult Austrians

Kudlacek, Stefan; Schneider, Barbara; Peterlik, Meinrad; Leb, G.; Klaushofer, Klaus; Weber, Kurt; Woloszczuk, W.; Willvonseder, R

doi:10.1046/j.1365-2362.2003.01127.x

Cited by 108 publications

(81 citation statements)

References 30 publications

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“…This value compares well with other reports of the vitamin D status in similar latitudes [12, 15, 16] and also with the report of Kudlacek et al [17] about the vitamin D status in the Austrian population. Surprisingly, one study found the average 25-D concentration to be only 4.4 ng/ml (11 nmol/l) although a similar RIA assay was used [18].…”

Section: Discussionsupporting

confidence: 92%

Vitamin D Status and Its Relation to Age and Body Mass Index

Bischof

Heinze²,

Vierhapper³

2006

Horm Res Paediatr

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Background/Aims: While numerous studies have examined 25(OH)-vitamin D₃ (25-D) concentrations and their relation to parathyroid hormone (PTH) levels there is only limited information on the interrelation between 25-D, 1,25(OH)₂-vitamin D₃ (1,25-D) and PTH. It was the aim of this study to assess the vitamin D endocrine system and its relation to age and body mass index (BMI). Methods: This cross-sectional study comprised a convenience sample of 483 adults which attended the endocrinology outpatient service of a university hospital in the years 2002–2004. Results: The mean concentrations of 25-D, 1,25-D, calcium and PTH were 21.0 ± 10.6 ng/ml, 47.9 ± 21.7 pg/ml, 9.48 ± 0.48 mg/dl and 51.0 ± 27.2 pg/ml, respectively. 25-D was related (p < 0.01) to BMI, age, PTH and 1,25-D. After correction for 25-D, we found no relation between BMI and 1,25-D. PTH was related (p < 0.01) to serum calcium, BMI, age and 1,25-D (p = 0015). There was a seasonal variation in both, 25-D and 1,25-D serum concentrations: 25-D levels were lowest in January and increased until July while the nadir and zenith of 1,25-D were found in April and October, respectively. Conclusion: Since BMI was negatively related to 25-D the prevalence of 25-D deficiency (<8.8 ng/ml) increased from 8.8% in subjects with BMI <30 kg/m² to 15.0% in subjects with BMI >30 kg/m². BMI, age and season should be taken into account when assessing a patients vitamin D status and more aggressive vitamin D supplementation should be considered for obese subjects.

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Section: Discussionsupporting

confidence: 92%

Vitamin D Status and Its Relation to Age and Body Mass Index

Bischof

Heinze²,

Vierhapper³

2006

Horm Res Paediatr

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“…As there is no consensus on an optimal vitamin D status (Lips, 2004;Dawson-Hughes et al, 2005;Aloia et al, 2006;Bischoff-Ferrari et al, 2006) and no standardization of vitamin D measurement (Lips et al, 1999;Binkley et al, 2004), comparison between different studies and results is rather difficult. However, our data are similar to results of other European studies concerning the prevalence of vitamin D deficiency from various countries in Europe (Burnand et al, 1992;Scharla et al, 1996;Chapuy et al, 1997;Woitge et al, 1998;Lamberg-Allardt et al, 2001;Kudlacek et al, 2003;Ovesen et al, 2003;MacFarlane et al, 2004;Meyer et al, 2004) and other continents (Sherman et al, 1990;Mc Kenna, 1992;Jacques et al, 1997;Looker et al, 2002;Rapuri et al, 2002;Hashemipour et al, 2004;Hanley and Davision, 2005), including countries located at low latitudes (Levis et al, 2005;Lucas et al, 2005). Moreover, studies considerably vary with respect to the recruitment and the age range of the included sample, and only few studies have been based on nationally representative samples (Chapuy et al, 1997;Finch et al, 1998;Looker et al, 2002;Hirani and Primatesta, 2005).…”

Section: Discussionsupporting

confidence: 89%

Vitamin D status and health correlates among German adults

et al. 2007

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Objective: To analyze vitamin D status based on serum 25-hydroxyvitamin D (25OHD) measurements, its determinants and health correlates in a representative sample of German adults. Subjects: A total of 1763 men and 2267 women, 18-to 79-year old, who participated in the representative German National Health Interview and Examination Survey 1998 and the integrated German Nutrition Survey. Results: The median vitamin D intake from both diet and supplements did not meet the recommended level of 5 mg/day, in either men (2.8 mg/day) or women (2.3 mg/day). Altogether 80.9% of men and 88.5% of women had vitamin D intakes below this level. Moderate (12.5-25 nmol/l serum 25OHD levels) and mild (25-50 nmol/l) vitamin D deficiency was prevalent in the adult population in Germany, even in younger age groups. Overall, 57% of men and 58% of women had vitamin D levels below 50 nmol/l. Among 65-to 79-year-old women, the proportion amounted to 75%, even during the sunnier half of the year. In sexspecific multiple linear regression models, independent determinants of serum 25OHD levels consistently included season, vitamin D intake from both diet and supplements, physical activity and living in a partnership. In addition, age and current menopausal hormone use contributed to the model among women, as opposed to time of day of blood sampling and body mass index (marginally) among men. Significantly lower serum 25OHD levels were observed in women with hypertension, cardiovascular diseases and noninsulin-treated diabetes mellitus as well as in men with insulin-treated diabetes mellitus compared with nonaffected participants. Conclusions: Vitamin D deficiency is a public health issue in Germany. We identified a number of determinants with potential for primary prevention of vitamin D deficiency. Risk and benefits of preventive actions need to be examined in further studies.

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“…In fact, the levels observed are higher than usually seen in healthy Austrians. 19 Thus, factors other than AED monotherapy may have contributed to the high rates of vitamin D deficiency ⁄ insufficiency or the altered bone turnover reported in earlier studies, [3][4][5][6][7][8] for example the inclusion of participants receiving AED polytherapy 2,8 or those with severe learning disability*, immobility, or cerebral palsy, or other groups at risk for vitamin D deficiency. The last group comprises institutionalized participants, participants with physical disability, low outdoor activity, malnutrition, or a different sociocultural lifestyle, and black participants.…”

Section: Discussionmentioning

confidence: 98%

Chronic antiepileptic monotherapy, bone metabolism, and body composition in non‐institutionalized children

Rauchenzauner

Griesmacher

Tatarczyk

et al. 2010

Develop Med Child Neuro

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AIM The aim of this study was to determine the influence of chronic monotherapy with antiepileptic drugs (AEDs) on vitamin D levels, bone metabolism, and body composition.METHOD Eighty-five children (38 males, 47 females; mean age 12y 5mo, SD 3y 4mo) were treated with valproate and 40 children (28 males, 12 females; mean age 11y 10mo, SD 3y) were treated with other AEDs (lamotrigine, sulthiame, or oxcarbazepine), comprising the non-valproate group. Forty-one healthy children (29 males 12 females; mean age 12y 1mo, SD 3y 5mo) served as a comparison group. Height, weight, body impedance analysis, 25-hydroxyvitamin D, calcium, phosphate, two bone resorption markers (receptor activator of nuclear factor jB ligand [RANKL] and tartrate-resistant acid phosphatase 5b [TRAP5b]), osteoprotegerin, and leptin were measured. RESULTS No child was vitamin D deficient as defined by a 25-hydroxyvitamin D (25OHD) level ofless than 25nmol ⁄ l (<10ng ⁄ ml). Leptin, body fat, weight standard deviation score (SDS), and body mass index (BMI) SDS were all significantly higher (each p<0.001) in valproate-treated children than in the non-valproate group, as were calcium (p=0.027) and RANKL (p=0.007) concentrations. Similarly, leptin was significantly higher in the valproate group than in control participants (p<0.001), as were body fat (p=0.023), weight SDS (p=0.046), BMI SDS (p=0.047), calcium (p<0.001), and RANKL (p<0.001), whereas TRAP5b concentrations were significantly lower in the valproate-treated group (p=0.002). Furthermore, calcium and RANKL levels were significantly higher in the non-valproate group than in comparison participants (p<0.001 and p=0.016 respectively).INTERPRETATION Non-enzyme-inducing or minimal enzyme-inducing AED monotherapy does not cause vitamin D deficiency in otherwise healthy children with epilepsy. Valproate therapy is associated with increases in weight, body fat, and leptin concentration, as well as with a bone metabolic profile that resembles slightly increased parathyroid hormone action.Chronic antiepileptic drug (AED) therapy has been associated with vitamin D deficiency, low bone mass, increased fracture risk, and altered bone turnover.1 The underlying pathophysiological mechanisms are poorly understood but are probably multifactorial. Most older AEDs (e.g. phenobarbital, phenytoin, and carbamazepine) are strong cytochrome P450 (CYP450) enzyme inducers, thereby causing altered steroid and vitamin D metabolism, whereas valproic acid (valproate) and the newer AEDs such as lamotrigine and oxcarbazepine are non-enzyme inducers or minimal enzyme inducers. Some, but not all, studies in adults treated with new AEDs have observed vitamin D deficiency (as defined by a 25-hydroxyvitamin D [25OHD] level <25nmol ⁄ l [<10ng ⁄ ml]) and low bone mineral density (BMD).2-4 Studies on the effect of chronic AED therapy on bone metabolism in children have produced conflicting results. Valproate monotherapy was first reported to reduce BMD in children. 5 Since then, most studies have failed to demonstrate low bone ma...

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Assessment of vitamin D and calcium status in healthy adult Austrians

Abstract: Prevalence of hypovitaminosis D in adult Austrians is an imminent risk for development of secondary hyperparathyroidism with advancing age, and requires timely correction of nutritional deficits.

Cited by 108 publications

References 30 publications

Vitamin D Status and Its Relation to Age and Body Mass Index

Vitamin D Status and Its Relation to Age and Body Mass Index

Vitamin D status and health correlates among German adults

Chronic antiepileptic monotherapy, bone metabolism, and body composition in non‐institutionalized children

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