Severe vitamin D deficiency is associated with frequently observed diseases in medical inpatients

A. Marra, G. Leoncini, M. Mussap, M. Bovio, E. Nazzari, M. Giusti, F. Minuto, G. Murialdo, P. Ameri

Research output: Contribution to journalArticle

Abstract

Introduction Vitamin D deficiency consequences may go beyond altered calcium homeostasis and musculoskeletal disease. Medical inpatients are often vitamin D-deficient, but little information is available about the relation of vitamin D status with extra-skeletal disorders in this population. Methods We analysed the relationship between the concentrations of 25-hydroxyvitamin D [25(OH)D], the marker of vitamin D status, and the conditions most commonly causing admission in 115 consecutive medical inpatients. Results Sixty-five subjects (56.5%) had severe vitamin D deficiency [25(OH)D <8 ng/ml]. Age (β = -0.35, p = 0.01) and hepatic disease (β = -0.21, p = 0.02) were significant correlates of 25(OH)D levels. Compared with patients with ≥ 8 ng/ml 25(OH)D, those with <8 ng/ml 25(OH)D had significantly higher parathyroid hormone (PTH) concentrations [123 (92.7-208.2) ng/l vs. 88 (68.5-129.5) ng/l, p <0.001], were significantly more likely to have arterial hypertension (OR 2.76, 95% CI 1.16-6.58), heart failure (HF) (OR 2.49, 95% CI 1.14-5.47), cerebrovascular disease (OR 3.23, 95% CI 1.41-7.39), and infections (OR 2.44, 95% CI 1.02-5.87), and stayed in hospital significantly longer (10 days vs. 7.5 days, p = 0.01). Only the probability of having an infection remained significantly higher in cases with severe vitamin D deficiency after adjustment for age (OR 2.41, 95% CI 1.03-5.68) and persisted after further correcting for presence of hepatic disease and PTH values (OR 2.66, 95% CI 1.03-6.88). A significant association between PTH and HF (OR 2.32, 95% CI 1.05-5.09) and length of hospitalisation (β = 0.22, p = 0.04) emerged in the fully adjusted regression models. Conclusions Severe vitamin D deficiency is associated with commonly presenting extra-skeletal diseases in medical inpatients. With the exception of infections, this association is mainly driven by age. Additional studies are needed to determine whether vitamin D testing on admission may help stratifying specific categories of patients by clinical severity.

Original languageEnglish
Pages (from-to)647-652
Number of pages6
JournalInternational Journal of Clinical Practice
Volume68
Issue number5
DOIs
Publication statusPublished - 2014

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Vitamin D Deficiency
Vitamin D
Inpatients
Parathyroid Hormone
Heart Failure
Infection
Musculoskeletal Diseases
Cerebrovascular Disorders
Liver
Hospitalization
Homeostasis
Hypertension
Calcium
Population

ASJC Scopus subject areas

  • Medicine(all)

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Severe vitamin D deficiency is associated with frequently observed diseases in medical inpatients. / Marra, A.; Leoncini, G.; Mussap, M.; Bovio, M.; Nazzari, E.; Giusti, M.; Minuto, F.; Murialdo, G.; Ameri, P.

In: International Journal of Clinical Practice, Vol. 68, No. 5, 2014, p. 647-652.

Research output: Contribution to journalArticle

Marra, A, Leoncini, G, Mussap, M, Bovio, M, Nazzari, E, Giusti, M, Minuto, F, Murialdo, G & Ameri, P 2014, 'Severe vitamin D deficiency is associated with frequently observed diseases in medical inpatients', International Journal of Clinical Practice, vol. 68, no. 5, pp. 647-652. https://doi.org/10.1111/ijcp.12323
Marra, A. ; Leoncini, G. ; Mussap, M. ; Bovio, M. ; Nazzari, E. ; Giusti, M. ; Minuto, F. ; Murialdo, G. ; Ameri, P. / Severe vitamin D deficiency is associated with frequently observed diseases in medical inpatients. In: International Journal of Clinical Practice. 2014 ; Vol. 68, No. 5. pp. 647-652.
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abstract = "Introduction Vitamin D deficiency consequences may go beyond altered calcium homeostasis and musculoskeletal disease. Medical inpatients are often vitamin D-deficient, but little information is available about the relation of vitamin D status with extra-skeletal disorders in this population. Methods We analysed the relationship between the concentrations of 25-hydroxyvitamin D [25(OH)D], the marker of vitamin D status, and the conditions most commonly causing admission in 115 consecutive medical inpatients. Results Sixty-five subjects (56.5{\%}) had severe vitamin D deficiency [25(OH)D <8 ng/ml]. Age (β = -0.35, p = 0.01) and hepatic disease (β = -0.21, p = 0.02) were significant correlates of 25(OH)D levels. Compared with patients with ≥ 8 ng/ml 25(OH)D, those with <8 ng/ml 25(OH)D had significantly higher parathyroid hormone (PTH) concentrations [123 (92.7-208.2) ng/l vs. 88 (68.5-129.5) ng/l, p <0.001], were significantly more likely to have arterial hypertension (OR 2.76, 95{\%} CI 1.16-6.58), heart failure (HF) (OR 2.49, 95{\%} CI 1.14-5.47), cerebrovascular disease (OR 3.23, 95{\%} CI 1.41-7.39), and infections (OR 2.44, 95{\%} CI 1.02-5.87), and stayed in hospital significantly longer (10 days vs. 7.5 days, p = 0.01). Only the probability of having an infection remained significantly higher in cases with severe vitamin D deficiency after adjustment for age (OR 2.41, 95{\%} CI 1.03-5.68) and persisted after further correcting for presence of hepatic disease and PTH values (OR 2.66, 95{\%} CI 1.03-6.88). A significant association between PTH and HF (OR 2.32, 95{\%} CI 1.05-5.09) and length of hospitalisation (β = 0.22, p = 0.04) emerged in the fully adjusted regression models. Conclusions Severe vitamin D deficiency is associated with commonly presenting extra-skeletal diseases in medical inpatients. With the exception of infections, this association is mainly driven by age. Additional studies are needed to determine whether vitamin D testing on admission may help stratifying specific categories of patients by clinical severity.",
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T1 - Severe vitamin D deficiency is associated with frequently observed diseases in medical inpatients

AU - Marra, A.

AU - Leoncini, G.

AU - Mussap, M.

AU - Bovio, M.

AU - Nazzari, E.

AU - Giusti, M.

AU - Minuto, F.

AU - Murialdo, G.

AU - Ameri, P.

PY - 2014

Y1 - 2014

N2 - Introduction Vitamin D deficiency consequences may go beyond altered calcium homeostasis and musculoskeletal disease. Medical inpatients are often vitamin D-deficient, but little information is available about the relation of vitamin D status with extra-skeletal disorders in this population. Methods We analysed the relationship between the concentrations of 25-hydroxyvitamin D [25(OH)D], the marker of vitamin D status, and the conditions most commonly causing admission in 115 consecutive medical inpatients. Results Sixty-five subjects (56.5%) had severe vitamin D deficiency [25(OH)D <8 ng/ml]. Age (β = -0.35, p = 0.01) and hepatic disease (β = -0.21, p = 0.02) were significant correlates of 25(OH)D levels. Compared with patients with ≥ 8 ng/ml 25(OH)D, those with <8 ng/ml 25(OH)D had significantly higher parathyroid hormone (PTH) concentrations [123 (92.7-208.2) ng/l vs. 88 (68.5-129.5) ng/l, p <0.001], were significantly more likely to have arterial hypertension (OR 2.76, 95% CI 1.16-6.58), heart failure (HF) (OR 2.49, 95% CI 1.14-5.47), cerebrovascular disease (OR 3.23, 95% CI 1.41-7.39), and infections (OR 2.44, 95% CI 1.02-5.87), and stayed in hospital significantly longer (10 days vs. 7.5 days, p = 0.01). Only the probability of having an infection remained significantly higher in cases with severe vitamin D deficiency after adjustment for age (OR 2.41, 95% CI 1.03-5.68) and persisted after further correcting for presence of hepatic disease and PTH values (OR 2.66, 95% CI 1.03-6.88). A significant association between PTH and HF (OR 2.32, 95% CI 1.05-5.09) and length of hospitalisation (β = 0.22, p = 0.04) emerged in the fully adjusted regression models. Conclusions Severe vitamin D deficiency is associated with commonly presenting extra-skeletal diseases in medical inpatients. With the exception of infections, this association is mainly driven by age. Additional studies are needed to determine whether vitamin D testing on admission may help stratifying specific categories of patients by clinical severity.

AB - Introduction Vitamin D deficiency consequences may go beyond altered calcium homeostasis and musculoskeletal disease. Medical inpatients are often vitamin D-deficient, but little information is available about the relation of vitamin D status with extra-skeletal disorders in this population. Methods We analysed the relationship between the concentrations of 25-hydroxyvitamin D [25(OH)D], the marker of vitamin D status, and the conditions most commonly causing admission in 115 consecutive medical inpatients. Results Sixty-five subjects (56.5%) had severe vitamin D deficiency [25(OH)D <8 ng/ml]. Age (β = -0.35, p = 0.01) and hepatic disease (β = -0.21, p = 0.02) were significant correlates of 25(OH)D levels. Compared with patients with ≥ 8 ng/ml 25(OH)D, those with <8 ng/ml 25(OH)D had significantly higher parathyroid hormone (PTH) concentrations [123 (92.7-208.2) ng/l vs. 88 (68.5-129.5) ng/l, p <0.001], were significantly more likely to have arterial hypertension (OR 2.76, 95% CI 1.16-6.58), heart failure (HF) (OR 2.49, 95% CI 1.14-5.47), cerebrovascular disease (OR 3.23, 95% CI 1.41-7.39), and infections (OR 2.44, 95% CI 1.02-5.87), and stayed in hospital significantly longer (10 days vs. 7.5 days, p = 0.01). Only the probability of having an infection remained significantly higher in cases with severe vitamin D deficiency after adjustment for age (OR 2.41, 95% CI 1.03-5.68) and persisted after further correcting for presence of hepatic disease and PTH values (OR 2.66, 95% CI 1.03-6.88). A significant association between PTH and HF (OR 2.32, 95% CI 1.05-5.09) and length of hospitalisation (β = 0.22, p = 0.04) emerged in the fully adjusted regression models. Conclusions Severe vitamin D deficiency is associated with commonly presenting extra-skeletal diseases in medical inpatients. With the exception of infections, this association is mainly driven by age. Additional studies are needed to determine whether vitamin D testing on admission may help stratifying specific categories of patients by clinical severity.

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