Department of Geriatric Medicine, Marien Hospital Herne, University Hospital, Ruhr-University Bochum, Hölkeskampring 40, D-44625, Herne, Germany.
BMC Geriatr. 2018 Sep 20;18(1):219. doi: 10.1186/s12877-018-0919-8.
Vitamin D deficiency is known to be highly prevalent in older persons. However, the prevalence in the subgroup of frail older hospitalized patients is not clear. We sought to investigate the prevalence and predictors of vitamin D deficiency in frail older hospitalized patients.
217 consecutively geriatric hospitalized patients with routine measurements of 25-hydroxyvitamin D [25 (OH)D] at hospital admission were analyzed retrospectively, including information of previous vitamin D supplementation and the geriatric assessment. Serum 25 (OH)D concentrations < 20 ng/ml and between 20 and 29.99 ng/ml were classified as deficient and insufficient, respectively, whereas concentrations ≥30 ng/ml were considered as desirable. A stepwise binary logistic regression model was performed to assess the simultaneous effects of age, gender and geriatric assessments on the prevalence of low vitamin D concentration.
Mean age of the cohort was 81.6 ± 8.0 years (70.0% females). Mean serum 25(OH)D was 12.7 ± 12.9 ng/ml. Of 167 (77%) subjects without known previous vitamin D supplementation, only 21 (12.6%) had serum concentrations ≥20 ng/ml and only 8 (4.2%) had desirable serum concentrations ≥30 ng/ml. In total population, 146 (87.4%) participants were vitamin D deficient. Despite vitamin D supplementation, 22 of 50 participants (44.0%) were vitamin D deficient and only 19 (38.0%) had desirable concentrations of ≥30 ng/ml. In a stepwise logistic regression analysis, only previous intake of vitamin D supplementation and high Geriatric Depression Scale score (GDS-15) were significantly associated with vitamin D deficiency.
In the group of frail older hospitalized patients without previous vitamin D supplementation, the prevalence of inadequate vitamin D concentrations is extremely high. Therefore, usefulness of the routine measurement of vitamin D status before initiating of supplementation appears to be questionable in this patient group.
维生素 D 缺乏症在老年人中非常普遍。然而，在体弱的老年住院患者亚组中的患病率尚不清楚。我们旨在研究体弱的老年住院患者中维生素 D 缺乏的患病率和预测因素。
回顾性分析了 217 例连续接受常规入院时 25-羟维生素 D [25（OH）D] 测量的老年住院患者，包括以往维生素 D 补充和老年评估的信息。血清 25（OH）D 浓度<20ng/ml 和 20-29.99ng/ml 分别被归类为缺乏和不足，而浓度≥30ng/ml 则被认为是理想的。采用逐步二项逻辑回归模型评估年龄、性别和老年评估对低维生素 D 浓度患病率的综合影响。
队列的平均年龄为 81.6±8.0 岁（70.0%为女性）。平均血清 25（OH）D 为 12.7±12.9ng/ml。在 167 名（77%）无已知既往维生素 D 补充的患者中，仅有 21 名（12.6%）的血清浓度≥20ng/ml，仅有 8 名（4.2%）的血清浓度理想，≥30ng/ml。在全人群中，146 名（87.4%）参与者存在维生素 D 缺乏。尽管进行了维生素 D 补充，仍有 50 名参与者中的 22 名（44.0%）存在维生素 D 缺乏，仅有 19 名（38.0%）的血清浓度理想，≥30ng/ml。在逐步逻辑回归分析中，只有既往摄入维生素 D 补充剂和较高的老年抑郁量表评分（GDS-15）与维生素 D 缺乏显著相关。
在未接受维生素 D 补充的体弱老年住院患者中，维生素 D 浓度不足的患病率极高。因此，在该患者群体中，在开始补充之前常规测量维生素 D 状态的用途似乎值得怀疑。
