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Hypovitaminosis D among rheumatology outpatients in clinical practice

Objectives. A role for vitamin D in the pathogenesis of autoimmune and inflammatory diseases is emerging. We undertook an audit of 25-hydroxyvitamin D (25OHD) investigation and treatment in rheumatology outpatients. Methods. Serum 25OHD requests were matched to electronic medical records from rheuma...

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Autores principales: Mouyis, M., Ostor, A. J. K., Crisp, A. J., Ginawi, A., Halsall, D. J., Shenker, N., Poole, K. E. S.
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518945/
https://www.ncbi.nlm.nih.gov/pubmed/18499714
http://dx.doi.org/10.1093/rheumatology/ken203
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author Mouyis, M.
Ostor, A. J. K.
Crisp, A. J.
Ginawi, A.
Halsall, D. J.
Shenker, N.
Poole, K. E. S.
author_facet Mouyis, M.
Ostor, A. J. K.
Crisp, A. J.
Ginawi, A.
Halsall, D. J.
Shenker, N.
Poole, K. E. S.
author_sort Mouyis, M.
collection PubMed
description Objectives. A role for vitamin D in the pathogenesis of autoimmune and inflammatory diseases is emerging. We undertook an audit of 25-hydroxyvitamin D (25OHD) investigation and treatment in rheumatology outpatients. Methods. Serum 25OHD requests were matched to electronic medical records from rheumatology and metabolic bone clinics (April 2006–March 2007). Data were analysed separately for two groups, ‘Documented osteoporosis/osteopaenia’ (Group 1) and ‘General rheumatology outpatients’ (Group 2, sub-divided by diagnosis). Hypovitaminosis D was defined by 25OHD levels <50 nmol/l. Values were compared with healthy adults to calculate geometric z-scores. Results. A total of 263 patients were included (Group 1, n = 122; Group 2, n = 141) with an overall median 25OHD of 44 nmol/l.The 25OHD level among general rheumatology patients (median 39 nmol/l, mean z score −1.2, was statistically significantly lower than among osteoporotic/osteopaenic patients (median 49 nmol/l, mean z score of −0.9, p < 0.05 for the difference). 25OHD was lower in inflammatory arthritis and chronic pain/fibromyalgia than in other groups. Prescribing was recorded in 100 in Group 1 (of whom 95% were prescribed calcium/800 IU cholecalciferol) and 83 in Group 2 (91% calcium/800 IU). Only 31% of the patients with 25OHD <50 nmol/l would have been identified using general guidelines for screening patients at ‘high risk’ of hypovitaminosis D. Conclusions. Improved guidelines for managing hypovitaminosis D in rheumatology patients are needed. We found a high prevalence of hypovitaminosis D among secondary care patients in rheumatology and widespread supplementation with 800 IU cholecalciferol. Substantially reduced levels of serum 25OHD were identified among patients with inflammatory arthritis and chronic pain.
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spelling pubmed-25189452009-02-25 Hypovitaminosis D among rheumatology outpatients in clinical practice Mouyis, M. Ostor, A. J. K. Crisp, A. J. Ginawi, A. Halsall, D. J. Shenker, N. Poole, K. E. S. Rheumatology (Oxford) Clinical Objectives. A role for vitamin D in the pathogenesis of autoimmune and inflammatory diseases is emerging. We undertook an audit of 25-hydroxyvitamin D (25OHD) investigation and treatment in rheumatology outpatients. Methods. Serum 25OHD requests were matched to electronic medical records from rheumatology and metabolic bone clinics (April 2006–March 2007). Data were analysed separately for two groups, ‘Documented osteoporosis/osteopaenia’ (Group 1) and ‘General rheumatology outpatients’ (Group 2, sub-divided by diagnosis). Hypovitaminosis D was defined by 25OHD levels <50 nmol/l. Values were compared with healthy adults to calculate geometric z-scores. Results. A total of 263 patients were included (Group 1, n = 122; Group 2, n = 141) with an overall median 25OHD of 44 nmol/l.The 25OHD level among general rheumatology patients (median 39 nmol/l, mean z score −1.2, was statistically significantly lower than among osteoporotic/osteopaenic patients (median 49 nmol/l, mean z score of −0.9, p < 0.05 for the difference). 25OHD was lower in inflammatory arthritis and chronic pain/fibromyalgia than in other groups. Prescribing was recorded in 100 in Group 1 (of whom 95% were prescribed calcium/800 IU cholecalciferol) and 83 in Group 2 (91% calcium/800 IU). Only 31% of the patients with 25OHD <50 nmol/l would have been identified using general guidelines for screening patients at ‘high risk’ of hypovitaminosis D. Conclusions. Improved guidelines for managing hypovitaminosis D in rheumatology patients are needed. We found a high prevalence of hypovitaminosis D among secondary care patients in rheumatology and widespread supplementation with 800 IU cholecalciferol. Substantially reduced levels of serum 25OHD were identified among patients with inflammatory arthritis and chronic pain. Oxford University Press 2008-09 2008-05-22 /pmc/articles/PMC2518945/ /pubmed/18499714 http://dx.doi.org/10.1093/rheumatology/ken203 Text en © 2008 The Author(s) http://creativecommons.org/licenses/by-nc/2.0/uk/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical
Mouyis, M.
Ostor, A. J. K.
Crisp, A. J.
Ginawi, A.
Halsall, D. J.
Shenker, N.
Poole, K. E. S.
Hypovitaminosis D among rheumatology outpatients in clinical practice
title Hypovitaminosis D among rheumatology outpatients in clinical practice
title_full Hypovitaminosis D among rheumatology outpatients in clinical practice
title_fullStr Hypovitaminosis D among rheumatology outpatients in clinical practice
title_full_unstemmed Hypovitaminosis D among rheumatology outpatients in clinical practice
title_short Hypovitaminosis D among rheumatology outpatients in clinical practice
title_sort hypovitaminosis d among rheumatology outpatients in clinical practice
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518945/
https://www.ncbi.nlm.nih.gov/pubmed/18499714
http://dx.doi.org/10.1093/rheumatology/ken203
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