Determinants of vitamin D status in patients with hip fracture and in elderly control subjects

Abstract

The factors that influence vitamin D status were investigated in 125 patients with hip fracture and in 74 elderly control subjects. The serum concentrations of 25-hydroxyvitamin D [25(OH)D] varied with sunshine score and were paralleled by serum 1,25-dihydroxyvitamin D [1,25(OH)2D]. The control subjects showed a higher sunshine score and higher serum 24(OH)D levels than the patients with hip fracture. Dietary vitamin D intake was similar in both groups (mean 115 IU/d). A positive correlation between vitamin D intake and serum 25(OH)D was observed in the patients with low sunshine exposure. It appeared from this relation that dietary vitamin D intake should be approximately 300 IU/d to maintain an adequate serum (25(OH)D concentration. Vitamin D status was very poor in patients who were institutionalized before hip fracture. Multiple regression analysis on serum 25(OH)D confirmed the primary role of sunshine exposure as determinant of vitamin D status. The principal determinants of serum 1,25(OH)2D were serum 25(OH)D, serum creatinine, and serum phosphate.

Change in plasma levels of vitamin D after consumption of cod-liver and fresh cod-liver oil as part of the traditional north Norwegian fish dish “Molje”

“…The correlation between the estimated daily vitamin D intake and 25(OH)D blood concentrations has been shown to be significant among subjects with low sun exposure (23,24). In our study, no such data was collected.…”

Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls

“…In a Norwegian study the Spearman correlation coef®cients between FFQ and 7-day food recording for vitamin D was even lower 0.14 (Andersen et al, 1995a). The correlation between S-25(OH)D and dietary intake of vitamin D has been 0.13 to 0.80 in previous studies (Lips et al, 1987;Krall et al, 1989;Salamone et al, 1993). In the present study at baseline, there was a statistically signi®cant but weak correlation between S-25(OH)D and intake of vitamin D as assessed by FFQ, but not by food recording.…”

“…Since the natural dietary sources of vitamin D are limited, rickets was previously fairly common in Finland, as in the other Scandinavian countries, until supplementation of the diet with vitamin D was started in the 1940s (Hallman et al, 1964). Currently vitamin D de®ciency occurs in elderly people in Europe (Heikinheimo et al, 1996;Lips et al, 1996) and it may be an important risk factor for osteoporotic hip fractures (Lips et al, 1987), as implied by the fact that supplementation with vitamin D and calcium reduces the risk of hip fractures and other nonvertebral fractures among elderly women (Chapuy et al, 1992;Dawson-Hughes et al, 1997). Many studies have shown a signi®cant correlation between the dietary vitamin D intake and the serum 25-hydroxyvitamin D [S-25(OH)D] concentration in the elderly (Lips et al, 1987;Krall et al, 1989;Salamone et al, 1993;Thomas et al, 1998).…”

Factors Associated with Cortical and Trabecular Bone Loss as Quantified by Peripheral Computed Tomography (pQCT) at the Ultradistal Radius in Aging Women

“…The differences in both parameters over the age range were equivalent to reductions of −0.41% and −0.65%, respectively, consistent with a continuing loss of skeletal integrity throughout life at the cortical and trabecular level. It has been postulated that enhanced PTH secretion, secondary to compromised vitamin D status or metabolism, may induce or exacerbate bone loss in older individuals [27][28][29]. Moreover, interventional data have confirmed the role of vitamin D deficiency in the pathogenesis of agerelated osteoporosis and indicated the need to maintain serum cholecalciferol levels within the normal range in elderly people [30].…”