J Am Geriatr Soc. 2012 Feb;60(2):251-5. doi: 10.1111/j.1532-5415.2011.03826.x. Epub 2012 Jan 27.
Terabe Y, Harada A, Tokuda H, Okuizumi H, Nagaya M, Shimokata H.
Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan. yst-trb at ncgg.go.jp
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.
Forty-eight nursing homes in Japan.
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.
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.
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) .
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.
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
– – – – – – – – – –
Could be poor kidney ==> low vitamin D production
Could be low level of vitamin D ==> poor kidney