Ca. Inderjeeth et al., Vitamin D deficiency and secondary hyperparathyroidism: clinical and biochemical associations in older non-institutionalised Southern Tasmanians, AUST NZ J M, 30(2), 2000, pp. 209-214
Citations number
31
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Aim: To determine the prevalence and associations of vitamin D (25-OHD) def
iciency in a sample of older Tasmanian subjects.
Methods: A cross-sectional survey of: 109 patients with a mean age of 79 ye
ars (range 60-101 years) consecutively admitted to a short stay geriatric r
ehabilitation ward; 52 community dwelling subjects with a mean age of 75 ye
ars (range 64-88 years). Subjects answered a questionnaire, had anthropomet
ric measurements and underwent venepuncture.
Results: The main outcome measure was 25 hydroxy vitamin D (25-OHD) level w
ith deficiency defined as <28 nmol/L. Vitamin D deficiency was found in 67%
and secondary hyperparathyroidism in 49% of the hospitalised group. Vitami
n D deficiency was also found in 17% of the community group, in particular
one in three residents of Independent Living Units was deficient. Subjects
who were deficient were older (80 years vs 76 years [p<0.001]), had lower b
ody mass index (23.7 kg/m(2) vs 25.9 kg/m(2) [p<0.001]) and had a lower ser
um albumin (35 gm/L vs 39 gm/L [p<0.001]). Deficient subjects had poorer ph
ysical functional status (p=0.02) and lower activity levels (p<0.001) and r
eported less habitual sun exposure (p<0.001). Biochemical measures such as
parathyroid hormone, alkaline phosphatase and calcium were weakly predictiv
e of vitamin D levels. By stepwise multiple regression analysis, the only s
ignificant predictors of vitamin D levels were the Frenchay Activity Index,
albumin and calcium.
Conclusion: Vitamin D deficiency and secondary hyperparathyroidism is commo
n in community living older people who are hospitalised in Southern Tasmani
a and is associated with increasing age, poor physical function and activit
y and low reported sun exposure.