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Vitamin D deficiency and osteoporosis in rehabilitation inpatients
Leonid M Shinchuk1, Leslie Morse, Nadia Huancahuari
1Department of Physical Medicine and Rehabilitation, Boston University Medical Center, Boston, MA, USA.
Objective:
To determine vitamin D status and bone mineral density (BMD) in patients admitted to a subacute rehabilitation facility.
Design:
Cross-sectional cohort study.
Setting:
Subacute rehabilitation facility.
Participants:
Fifty-three community-dwelling patients admitted from June through February 2005.
Interventions:
Not applicable.
Main Outcome Measures:
BMD, 25-hydroxyvitamin D (25[OH]D), C-telopeptide (CTX), osteocalcin, and dietary milk intake.
Results:
Prevalence of vitamin D deficiency (25[OH]D <20 ng/mL) was 49.1%, while a total of 83% of patients were either vitamin D deficient or insufficient (25[OH]D <30 ng/mL). The prevalence of osteopenia (T score, <-1) was 52.8%; osteoporosis (T score, <-2.5) was 17.0%. CTX (bone resorption marker) was elevated in 60.4% of patients. Osteocalcin (bone formation marker) was elevated in 13.2% of patients. Measurements of bone resorption and formation positively correlated (R2 = .22) indicating increased bone remodeling.
Conclusions:
Vitamin D deficiency and osteopenia and osteoporosis were highly prevalent in patients admitted for rehabilitation. Elevated bone resorption and remodeling were evident. This could be due to vitamin D deficiency that should be corrected before antiresorptive therapy is considered. The study emphasizes the need for vigilance for vitamin D status and BMD testing in patients admitted to rehabilitation facilities.
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