Document Detail


Vitamin D deficiency and secondary hyperparathyroidism are common complications in patients with peripheral arterial disease.
MedLine Citation:
PMID:  12220361     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate via the vitamin D status whether patients with peripheral arterial disease (PAD) tend to develop vitamin D deficiency that in turn influences their clinical symptoms.
DESIGN: Cross-sectional.
SETTING: University hospital.
PATIENTS AND PARTICIPANTS: Three hundred twenty-seven patients were evaluated; subjects with secondary causes of bone disease or bone active medication were excluded. One hundred sixty-one patients with either PAD stage II (n = 84) or stage IV (n = 77) were enrolled and compared to 45 age- and sex-matched healthy controls.
MEASUREMENTS AND MAIN RESULTS: All patients underwent determinations of serum chemistry, 25-hydroxyvitamin D (vitamin D3) intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and osteocalcin and were further stratified according to an individual restriction score into 3 groups: mildly, moderately, or severely restricted in daily life due to the underlying disease. Patients with PAD IV showed significantly lower vitamin D3 (P =.0001), and calcium (P =.0001) values and significantly higher iPTH (P =.0001), osteocalcin (P =.0001) and ALP (P =.02) levels as compared to patients with PAD II. Patients considering themselves as severely restricted due to the underlying disease showed lower vitamin D3 and higher iPTH levels than those who described only a moderate (vitamin D3: P <.001; iPTH: P <.01) or mild (vitamin D3: P <.001; iPTH: P <.001) restriction in daily life.
CONCLUSION: Patients with PAD IV, especially those who feel severely restricted due to the disease, are at high risk of developing vitamin D deficiency, secondary hyperparathyroidism, and ultimately osteomalacia due to immobilization and subsequent lack of exposure to sunlight, all of which in turn lead to further deterioration. Monitoring of vitamin D metabolism and vitamin D replacement therapy could be a simple, inexpensive approach to mitigating clinical symptoms and improving quality of life in patients with advanced PAD.
Authors:
Astrid Fahrleitner; Harald Dobnig; Andrea Obernosterer; Ernst Pilger; Georg Leb; Kurt Weber; Stefan Kudlacek; Barbara M Obermayer-Pietsch
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of general internal medicine     Volume:  17     ISSN:  0884-8734     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-10     Completed Date:  2002-12-03     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  663-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Endocrinology, Karl-Franzens University, Graz, Austria. astrid.fahrleitner@kfunigraz.ac.at
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Cholecalciferol / blood
Cross-Sectional Studies
Female
Humans
Hyperparathyroidism, Secondary / blood,  etiology*
Immobilization
Male
Pain Measurement / methods
Parathyroid Hormone / blood
Peripheral Vascular Diseases / blood,  complications*
Prevalence
Quality of Life
Questionnaires
Sunlight
Time Factors
Vitamin D Deficiency / blood,  etiology*
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 67-97-0/Cholecalciferol
Comments/Corrections
Comment In:
J Gen Intern Med. 2002 Sep;17(9):733-5   [PMID:  12220371 ]

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