Cargando…
Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition
Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive d...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357065/ https://www.ncbi.nlm.nih.gov/pubmed/30634546 http://dx.doi.org/10.3390/nu11010128 |
_version_ | 1783391708577267712 |
---|---|
author | Boccardi, Virginia Lapenna, Maria Gaggi, Lorenzo Garaffa, Francesco Maria Croce, Michele Francesco Baroni, Marta Ercolani, Sara Mecocci, Patrizia Ruggiero, Carmelinda |
author_facet | Boccardi, Virginia Lapenna, Maria Gaggi, Lorenzo Garaffa, Francesco Maria Croce, Michele Francesco Baroni, Marta Ercolani, Sara Mecocci, Patrizia Ruggiero, Carmelinda |
author_sort | Boccardi, Virginia |
collection | PubMed |
description | Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D is a marker of organ diseases is still under debate. We aimed to investigate whether comorbidities were associated with serum 25(OH)D levels in geriatric inpatients. Methods: This is a retrospective study, including 237 subjects consecutively admitted to an acute care geriatric unit, with available data of 25(OH)D serum concentrations. 25(OH)D serum levels were defined according to the following cutoffs: 50–30 ng/mL (125–75 nmol/L): optimal range; 30–20 ng/mL (75–50 nmol/L): insufficiency; 20–10 ng/mL (5–25 nmol/L): deficiency; and <10 ng/mL (<25 nmol/L): severe deficiency. Comorbidity was assessed using the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Two summary measures were obtained, the Illness Severity Index (CIRS-SI) and the Comorbidity Index (CIRS-CI). Results: 177 (74.68%) women and 60 (25.32%) men with mean age of 85 ± 6 years old were enrolled. The majority of subjects (68.6%) were at risk of malnutrition. Overall, the burden of comorbidity was 1.87 ± 1.33 for CIRS-CI and 1.18 ± 0.40 for CIRS-SI. 25(OH)D serum concentrations were 10.58 ± 7.68 ng/mL, with 98.7% of subjects having vitamin D below 30 ng/mL and 56.6% with severe deficiency. An inverse correlation was found between 25(OH)D and both CIRS-SI (r: −0.312; p < 0.0001) and CIRS-CI (r: −0.306; p < 0.0001). Independent of multiple covariates an inverse association between both CIRS-SI (p < 0.0001) and CIRS-CI (p < 0.0001) and 25(OH)D was confirmed. Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. An inverse correlation was confirmed between serum 25(OH)D concentrations and CRP (r = −0.142; p = 0.041). CRP, in turn, positively correlated with CIRS-SI (r = 0.209, p = 0.003) and CIRS-CI (r = 0.158, p = 0.023). Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. Conclusions: In hospitalized very old subjects, a higher comorbidity burden is associated with lower 25(OH)D serum levels. Hypovitaminosis D was correlated with higher inflammatory status, which, together with the comorbidities burden, negatively influenced the length of hospital stay. |
format | Online Article Text |
id | pubmed-6357065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63570652019-02-04 Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition Boccardi, Virginia Lapenna, Maria Gaggi, Lorenzo Garaffa, Francesco Maria Croce, Michele Francesco Baroni, Marta Ercolani, Sara Mecocci, Patrizia Ruggiero, Carmelinda Nutrients Article Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D is a marker of organ diseases is still under debate. We aimed to investigate whether comorbidities were associated with serum 25(OH)D levels in geriatric inpatients. Methods: This is a retrospective study, including 237 subjects consecutively admitted to an acute care geriatric unit, with available data of 25(OH)D serum concentrations. 25(OH)D serum levels were defined according to the following cutoffs: 50–30 ng/mL (125–75 nmol/L): optimal range; 30–20 ng/mL (75–50 nmol/L): insufficiency; 20–10 ng/mL (5–25 nmol/L): deficiency; and <10 ng/mL (<25 nmol/L): severe deficiency. Comorbidity was assessed using the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Two summary measures were obtained, the Illness Severity Index (CIRS-SI) and the Comorbidity Index (CIRS-CI). Results: 177 (74.68%) women and 60 (25.32%) men with mean age of 85 ± 6 years old were enrolled. The majority of subjects (68.6%) were at risk of malnutrition. Overall, the burden of comorbidity was 1.87 ± 1.33 for CIRS-CI and 1.18 ± 0.40 for CIRS-SI. 25(OH)D serum concentrations were 10.58 ± 7.68 ng/mL, with 98.7% of subjects having vitamin D below 30 ng/mL and 56.6% with severe deficiency. An inverse correlation was found between 25(OH)D and both CIRS-SI (r: −0.312; p < 0.0001) and CIRS-CI (r: −0.306; p < 0.0001). Independent of multiple covariates an inverse association between both CIRS-SI (p < 0.0001) and CIRS-CI (p < 0.0001) and 25(OH)D was confirmed. Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. An inverse correlation was confirmed between serum 25(OH)D concentrations and CRP (r = −0.142; p = 0.041). CRP, in turn, positively correlated with CIRS-SI (r = 0.209, p = 0.003) and CIRS-CI (r = 0.158, p = 0.023). Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. Conclusions: In hospitalized very old subjects, a higher comorbidity burden is associated with lower 25(OH)D serum levels. Hypovitaminosis D was correlated with higher inflammatory status, which, together with the comorbidities burden, negatively influenced the length of hospital stay. MDPI 2019-01-09 /pmc/articles/PMC6357065/ /pubmed/30634546 http://dx.doi.org/10.3390/nu11010128 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Boccardi, Virginia Lapenna, Maria Gaggi, Lorenzo Garaffa, Francesco Maria Croce, Michele Francesco Baroni, Marta Ercolani, Sara Mecocci, Patrizia Ruggiero, Carmelinda Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title | Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title_full | Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title_fullStr | Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title_full_unstemmed | Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title_short | Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition |
title_sort | hypovitaminosis d: a disease marker in hospitalized very old persons at risk of malnutrition |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357065/ https://www.ncbi.nlm.nih.gov/pubmed/30634546 http://dx.doi.org/10.3390/nu11010128 |
work_keys_str_mv | AT boccardivirginia hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT lapennamaria hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT gaggilorenzo hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT garaffafrancescomaria hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT crocemichelefrancesco hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT baronimarta hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT ercolanisara hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT mecoccipatrizia hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition AT ruggierocarmelinda hypovitaminosisdadiseasemarkerinhospitalizedveryoldpersonsatriskofmalnutrition |