
PMID- 10475862
OWN - NLM
STAT- MEDLINE
DCOM- 19990827
LR  - 20260128
IS  - 0002-0729 (Print)
IS  - 0002-0729 (Linking)
VI  - 28
IP  - 3
DP  - 1999 May
TI  - Effect of immobilization on vitamin D status and bone mass in chronically 
      hospitalized disabled stroke patients.
PG  - 265-9
AB  - OBJECTIVE: To assess the influence of immobilization upon vitamin D status and 
      bone mass in chronically hospitalized, disabled, elderly patients following 
      stroke. DESIGN: cross-sectional study. SETTING: Department of geriatric neurology 
      in a Japanese hospital. SUBJECTS: 129 chronically hospitalized, disabled, elderly 
      stroke patients and 28 age-matched controls. RESULTS: We observed a deficiency of 
      both 1,25-dihydroxyvitamin D (1,25-[OH]2D; 24.3 pg/ml) and 25-hydroxyvitamin D 
      concentrations (25-OHD; 11.7 ng/ml) in stroke patients compared with controls. A 
      high serum ionized calcium (mean; 2.648 mEq/l) was an independent determinant of 
      the Barthel index (66) and 1,25-[OH]2D. When the patients were categorized into 
      three groups by 25-OHD level (deficient, insufficient and sufficient), there was 
      no difference in the mean 1,25-[OH]2D levels. Parathyroid hormone levels were 
      normal or low and did not correlate with 25-OHD. Serum bone turnover variables 
      and bone mineral density (BMD) of the second metacarpal in patients were 
      significantly decreased compared to control subjects. Independent determinants of 
      BMD included Barthel index, 25-OHD and 1,25-[OH]2D. CONCLUSIONS: 1,25-[OH]2D 
      deficiency in immobilized stroke patients is not caused by substrate (25-OHD) 
      deficiency but by hypercalcaemia. Immobilization-induced hypercalcaemia may 
      inhibit parathyroid hormone secretion and thus 1,25-[OH]2D production, resulting 
      in decreased BMD. Immobilization itself also may be responsible for decreased 
      BMD. Exogenous 1,25-[OH]2D (calcitriol) rather than dietary vitamin D 
      supplementation may be required in disabled elderly stroke patients who have a 
      deficiency of 1,25-[OH]2D in order to prevent hip fractures, which frequently 
      occur in this population.
FAU - Sato, Y
AU  - Sato Y
AD  - Department of Neurology, Futase Social Insurance Hospital, Iizuka, Japan. 
      y-sato@ktarn.or.jp
FAU - Kuno, H
AU  - Kuno H
FAU - Asoh, T
AU  - Asoh T
FAU - Honda, Y
AU  - Honda Y
FAU - Oizumi, K
AU  - Oizumi K
LA  - eng
PT  - Journal Article
PL  - England
TA  - Age Ageing
JT  - Age and ageing
JID - 0375655
RN  - 0 (Parathyroid Hormone)
RN  - 1406-16-2 (Vitamin D)
RN  - 66772-14-3 (1,25-dihydroxyvitamin D)
RN  - A288AR3C9H (25-hydroxyvitamin D)
RN  - SY7Q814VUP (Calcium)
SB  - IM
ECI - Age Ageing. 2019 Feb 5;48(2):312. doi: 10.1093/ageing/afy221. PMID: 30721916
MH  - Aged
MH  - Bone Density/*physiology
MH  - Bone and Bones/physiopathology
MH  - Calcium/blood
MH  - Cerebrovascular Disorders/*physiopathology/rehabilitation
MH  - Cross-Sectional Studies
MH  - *Persons with Disabilities
MH  - Female
MH  - *Hospitalization
MH  - Humans
MH  - Immobilization/*physiology
MH  - Japan
MH  - Long-Term Care
MH  - Male
MH  - Parathyroid Hormone/blood
MH  - Reference Values
MH  - Risk Factors
MH  - Vitamin D/analogs & derivatives/blood
MH  - Vitamin D Deficiency/*physiopathology/rehabilitation
EDAT- 1999/09/04 00:00
MHDA- 1999/09/04 00:01
CRDT- 1999/09/04 00:00
PHST- 1999/09/04 00:00 [pubmed]
PHST- 1999/09/04 00:01 [medline]
PHST- 1999/09/04 00:00 [entrez]
AID - 10.1093/ageing/28.3.265 [doi]
PST - ppublish
SO  - Age Ageing. 1999 May;28(3):265-9. doi: 10.1093/ageing/28.3.265.
