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After hip surgery Vitamin D levels dropped by 32 percent – Sept 2018

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study.

Ann Nutr Metab. 2018 Sep 25;73(3):252-260. doi: 10.1159/000492938. [Epub ahead of print]
Visser E1, de Roos NM1, Oosting E2, Endenburg SC3, Dronkers JJ2.
1 Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands.
2 Department of Physical Therapy, Gelderse Vallei Hospital, Ede, the Netherlands.
3 Department of Clinical Chemistry and Hematology, Gelderse Vallei Hospital, Ede, the Netherlands.


BACKGROUND:
Insufficient serum vitamin D concentrations (50-75 nmol/L) are prevalent in 40-65% of patients who require total hip arthroplasty (THA). This could impair physical recovery after surgery. This study investigated the association between preoperative vitamin D status and physical performance after THA. Additionally, postoperative changes in vitamin D concentrations were measured.

METHODS:
We included 87 patients scheduled for elective THA and aged ≥65 years. Three groups were recruited: patients classified as vitamin D deficient (< 50 nmol/L, n = 23), insufficient (50-75 nmol/L, n = 32), or sufficient (> 75 nmol/L, n = 32). Serum 25-hydroxyvitamin D3 (25OHD3) concentration and physical performance were measured perioperatively. Linear mixed models were used to examine differences between groups.

RESULTS:
Change in physical performance over time was not affected by preoperative vitamin D status. In contrast, for physical activity, both vitamin D (p = 0.021) and time (p < 0.001) effect was seen: from

  • 80.2 ± 25.8 to 58.1 ± 17.8 min/day in the deficient group,
  • 143.7 ± 19.8 to 92.9 ± 11.5 min/day in the insufficient group, and
  • 108.1 ± 20.9 to 62.3 ± 12.9 min/day in the sufficient group.

The Chair Stand Test, Timed Up and Go test, and 10-Meter Walking Test also improved significantly over time, but independent of vitamin D status. An increase in 25(OH)D3 concentration 6 weeks postoperatively was correlated with improved hip function (Pearson's r = -0.471, p = 0.018).
Overall, serum 25(OH)D3 declined with 32% one day after surgery (p < 0.001), to nearly return to baseline values 6 weeks later in all groups.

CONCLUSION:
Vitamin D status did not appear to affect physical recovery after THA.
The drop in vitamin D after surgery deserves further investigation, but could possibly be explained by hemodilution.

Created by admin. Last Modification: Thursday September 27, 2018 16:09:26 GMT-0000 by admin. (Version 2)
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