Vitamin D deficiency is associated with reduced mobility after hip fracture surgery : a prospective study
Copyright © The Author(s) on behalf of the American Society for Nutrition 2020..
BACKGROUND: Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population.
OBJECTIVE: This study aims to determine whether 25-hydroxyvitamin D [25(OH)D] concentration or the Geriatric Nutritional Risk Index (GNRI) is associated with mortality or rates of walking in a patient cohort after hip fracture surgery.
METHODS: Patients undergoing hip fracture repair from a multisite study in North America were included. Mortality and mobility were assessed at 30 and 60 d after surgery. Serum albumin, 25(OH)D, and intact parathyroid hormone were measured. Patients were characterized according to 25(OH)D <12 ng/mL, 12 to <20 ng/mL, 20 to <30 ng/mL, or ≥30 ng/mL. GNRI was categorized into major/moderate nutritional risk (<92), some risk (92 to <98), or in good nutritional status (≥98).
RESULTS: Of the 290 patients [aged 82 ± 7 y, BMI (kg/m2): 25 ± 5], 73% were women. Compared with patients with <12 ng/mL, those with higher 25(OH)D concentrations had higher rates of walking at 30 d (P = 0.031): 12 to <20 ng/mL (adjusted OR: 2.61; 95% CI: 1.13, 5.99); 20 to <30 ng/mL (3.48; 1.53, 7.95); ≥30 ng/mL (2.84; 1.12, 7.20). In addition, there was also greater mobility at 60 d (P = 0.028) in patients with higher 25(OH)D compared with the reference group (<12 ng/mL). Poor nutritional status (GNRI <92) showed an overall trend to reduce mobility (unadjusted P = 0.044 and adjusted P = 0.056) at 30 but not at 60 d. There was no association of vitamin D or GNRI with mortality at either time.
CONCLUSIONS: Vitamin D deficiency (<12 ng/mL) is associated with reduced ambulation after hip fracture surgery, whereas GNRI also contributes to immobility but is a less reliable predictor. Mechanisms that can explain why vitamin D deficiency is associated with mobility should be addressed in future studies.
| Errataetall: |
CommentIn: Am J Clin Nutr. 2020 Sep 1;112(3):507-509. - PMID 32710753 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:112 |
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| Enthalten in: |
The American journal of clinical nutrition - 112(2020), 3 vom: 01. Sept., Seite 613-618 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hao, Lihong [VerfasserIn] |
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| Links: |
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| Themen: |
1406-16-2 |
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| Anmerkungen: |
Date Completed 25.09.2020 Date Revised 14.02.2023 published: Print CommentIn: Am J Clin Nutr. 2020 Sep 1;112(3):507-509. - PMID 32710753 Citation Status MEDLINE |
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| doi: |
10.1093/ajcn/nqaa029 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM306675064 |
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| 245 | 1 | 0 | |a Vitamin D deficiency is associated with reduced mobility after hip fracture surgery |b a prospective study |
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| 500 | |a Date Completed 25.09.2020 | ||
| 500 | |a Date Revised 14.02.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Clin Nutr. 2020 Sep 1;112(3):507-509. - PMID 32710753 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © The Author(s) on behalf of the American Society for Nutrition 2020. | ||
| 520 | |a BACKGROUND: Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population | ||
| 520 | |a OBJECTIVE: This study aims to determine whether 25-hydroxyvitamin D [25(OH)D] concentration or the Geriatric Nutritional Risk Index (GNRI) is associated with mortality or rates of walking in a patient cohort after hip fracture surgery | ||
| 520 | |a METHODS: Patients undergoing hip fracture repair from a multisite study in North America were included. Mortality and mobility were assessed at 30 and 60 d after surgery. Serum albumin, 25(OH)D, and intact parathyroid hormone were measured. Patients were characterized according to 25(OH)D <12 ng/mL, 12 to <20 ng/mL, 20 to <30 ng/mL, or ≥30 ng/mL. GNRI was categorized into major/moderate nutritional risk (<92), some risk (92 to <98), or in good nutritional status (≥98) | ||
| 520 | |a RESULTS: Of the 290 patients [aged 82 ± 7 y, BMI (kg/m2): 25 ± 5], 73% were women. Compared with patients with <12 ng/mL, those with higher 25(OH)D concentrations had higher rates of walking at 30 d (P = 0.031): 12 to <20 ng/mL (adjusted OR: 2.61; 95% CI: 1.13, 5.99); 20 to <30 ng/mL (3.48; 1.53, 7.95); ≥30 ng/mL (2.84; 1.12, 7.20). In addition, there was also greater mobility at 60 d (P = 0.028) in patients with higher 25(OH)D compared with the reference group (<12 ng/mL). Poor nutritional status (GNRI <92) showed an overall trend to reduce mobility (unadjusted P = 0.044 and adjusted P = 0.056) at 30 but not at 60 d. There was no association of vitamin D or GNRI with mortality at either time | ||
| 520 | |a CONCLUSIONS: Vitamin D deficiency (<12 ng/mL) is associated with reduced ambulation after hip fracture surgery, whereas GNRI also contributes to immobility but is a less reliable predictor. Mechanisms that can explain why vitamin D deficiency is associated with mobility should be addressed in future studies | ||
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| 650 | 4 | |a mortality | |
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| 700 | 1 | |a Shapses, Sue A |e verfasserin |4 aut | |
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