Document Detail


25-hydroxyvitamin D, parathyroid hormone, and functional recovery after hip fracture in elderly patients.
MedLine Citation:
PMID:  16369897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is increasing interest in the effects of vitamin D and parathyroid hormone (PTH) on extraskeletal tissues, including the muscle. These effects may explain impairment in functional ability found in vitamin D-deficient subjects. Our aim was to investigate the roles of vitamin D and PTH in affecting the ability to perform activities of daily living after hip fracture. We studied 456 of 521 hip-fracture patients admitted consecutively to a rehabilitation hospital. Functional outcome was assessed after acute inpatient rehabilitation by using the Barthel index score. The functional scores were significantly correlated with serum levels of 25-hydroxyvitamin D (rho = 0.190; P < 0.001) and PTH (rho = -0.164; P < 0.001) and the 25-hydroxyvitamin D/PTH ratio (rho = 0.261; P < 0.001). At multiple regression, 25-hydroxyvitamin D and PTH levels were independently associated with Barthel index scores. The correlation between the 25-hydroxyvitamin D/PTH ratio and Barthel index scores was significantly stronger than the one between 25-hydroxyvitamin D and Barthel index scores (difference between the two correlation coefficients = 0.071; 95% CI = 0.009-0.133; P = 0.011). The significant association between the 25-hydroxyvitamin D/PTH ratio and the Barthel index scores persisted after adjustment for 12 prognostic factors (P = 0.012). On the whole, the panel of prognostic factors we studied predicted 50.1% of the variance of the functional score. Data shows that PTH and 25-hydroxyvitamin D were significantly associated with the ability to function after hip fracture and suggest that the two hormones act through independent mechanisms. The 25-hydroxyvitamin D/PTH ratio significantly contributed to a predictive model of functional outcome.
Authors:
Marco Di Monaco; Fulvia Vallero; Roberto Di Monaco; Rosa Tappero; Alberto Cavanna
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of bone and mineral metabolism     Volume:  24     ISSN:  0914-8779     ISO Abbreviation:  J. Bone Miner. Metab.     Publication Date:  2006  
Date Detail:
Created Date:  2005-12-21     Completed Date:  2006-03-02     Revised Date:  2006-06-29    
Medline Journal Info:
Nlm Unique ID:  9436705     Medline TA:  J Bone Miner Metab     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  42-7     Citation Subset:  IM    
Affiliation:
Osteoporosis Research Center, Presidio Sanitario San Camillo, Strada Santa Margherita 136, 10131 Torino, Italy. Medici@h-sancamillo.to.it
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Aged, 80 and over
Bone Density
Female
Hip Fractures / blood,  rehabilitation*
Humans
Linear Models
Male
Parathyroid Hormone / analogs & derivatives*,  blood,  physiology
Prognosis
Recovery of Function / physiology*
Statistics, Nonparametric
Vitamin D / analogs & derivatives*,  blood,  physiology
Vitamin D Deficiency
Chemical
Reg. No./Substance:
0/PTH protein, human; 0/Parathyroid Hormone; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D

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