Premium
Vitamin D Deficiency in Elderly Women in Nursing Homes: Investigation with Consideration of Decreased Activation Function from the Kidneys
Author(s) -
Terabe Yasuhito,
Harada Atsushi,
Tokuda Haruhiko,
Okuizumi Hiroyasu,
Nagaya Masahiro,
Shimokata Hiroshi
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03826.x
Subject(s) - medicine , vitamin d and neurology , parathyroid hormone , creatinine , vitamin d deficiency , renal function , nursing homes , endocrinology , osteocalcin , vitamin , calcifediol , alkaline phosphatase , calcium , nursing , biochemistry , chemistry , enzyme
Objectives To determine the approximate percentage of women in nursing homes who have vitamin D deficiency and to investigate whether, in assessing vitamin D status in elderly women, there are problems with measuring only 25 hydroxy‐vitamin D 3 (25( OH ) D 3 ) and whether decreased vitamin D activation as a result of poor renal function needs to be considered. Design Cross‐sectional study. Setting Forty‐eight nursing homes in J apan. Participants Four hundred three women with a mean age of 86.5 living in nursing homes who had participated in a clinical trial for hip protectors and were not bedridden. Measurements At the start of the trial, in addition to general biochemical data, 25( OH ) D 3 , 1,25‐dihydroxy‐vitamin D 3 (1,25( OH ) 2 D 3 ), intact parathyroid hormone (intact PTH ), calcium (Ca), phosphorus (P), bone alkaline phosphate ( BAP ), cross‐linked N ‐telopeptide of type I collagen ( NTx ), and osteocalcin were measured in participants’ blood, and statistical analysis was performed. Results 25(OH)D 3 , which is thought to reflect vitamin D status in the body, was surveyed and found to have a mean value of 16.7 ng/mL. 25(OH)D 3 was less than 16 ng/mL in 49.1% of all participants. Creatinine clearance ( CCr ) was less than 30 mL/min in 20.1% of participants. Participants with serum 25(OH)D 3 less than 16 ng/mL and CCr less than 30 mL/min had significantly higher levels of intact PTH and serum NTx . Participants with a CCr less than 30 mL/min had significantly lower levels of 1,25(OH) 2 D 3 . Conclusion Frail elderly adults living in nursing homes with poor renal function had lower 1,25( OH ) 2 D 3 and higher intact PTH levels and were thus thought to have poorer vitamin D activating capacity. Supplementation with cholecalciferol may be insufficient in people who have poor renal function.