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J Intern Med. 2004 Jul;256(1):56-62.

Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease.

Author information

1
Department of Respiratory Medicine, Rikshospitalet, Oslo, Norway. liv.forli@rikshospitalet.no

Abstract

OBJECTIVE:

To study the influence of underweight, body composition and vitamin D deficiency on bone mineral density in patients with advanced pulmonary disease.

DESIGN:

Cross-sectional study with time span for inclusion set at 5 years.

SETTING:

The clinical work and biochemical analyses were carried out at Rikshospitalet University Hospital, Norway. Analyses for vitamin D metabolites and bone markers were carried out at Aker University Hospital, and bone measurements at Clinic of Osteoporosis.

SUBJECTS:

Seventy-one candidates for lung transplantation (63% chronic obstructive pulmonary disease, 42 underweight and 29 normal weight) were included.

MAIN OUTCOME MEASURES:

Body composition, bone mineral density at lumbar spine and femur neck, serum concentration of calcidiol and vitamin D intake.

RESULTS:

Subnormal calcidiol levels were present in 52% of the underweight patients and 69% of the normal-weight patients. The resulting models of linear regression showed that for the lumbar spine T scores model, the total variation of 16.7% was explained by group (underweight/normal weight), sex and age. For the femur neck T scores model, the total variation of 20.4% was explained by the interaction of underweight and vitamin D deficiency (with borderline significance) and by arm muscle circumference percentage of standard. In patients with normal calcidiol levels, the median intake of vitamin D was 17 microg in the underweight patients and 11 microg in the normal-weight patients.

CONCLUSIONS:

Vitamin D deficiency was common in both underweight and normal-weight patients, but only in the underweight patients, an association between vitamin D deficiency and reduced femur neck T scores was indicated.

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