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Nutrients 2019, 11(1), 128; https://doi.org/10.3390/nu11010128

Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition

Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy
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Received: 5 December 2018 / Revised: 3 January 2019 / Accepted: 7 January 2019 / Published: 9 January 2019
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Abstract

Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D is a marker of organ diseases is still under debate. We aimed to investigate whether comorbidities were associated with serum 25(OH)D levels in geriatric inpatients. Methods: This is a retrospective study, including 237 subjects consecutively admitted to an acute care geriatric unit, with available data of 25(OH)D serum concentrations. 25(OH)D serum levels were defined according to the following cutoffs: 50–30 ng/mL (125–75 nmol/L): optimal range; 30–20 ng/mL (75–50 nmol/L): insufficiency; 20–10 ng/mL (5–25 nmol/L): deficiency; and <10 ng/mL (<25 nmol/L): severe deficiency. Comorbidity was assessed using the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Two summary measures were obtained, the Illness Severity Index (CIRS-SI) and the Comorbidity Index (CIRS-CI). Results: 177 (74.68%) women and 60 (25.32%) men with mean age of 85 ± 6 years old were enrolled. The majority of subjects (68.6%) were at risk of malnutrition. Overall, the burden of comorbidity was 1.87 ± 1.33 for CIRS-CI and 1.18 ± 0.40 for CIRS-SI. 25(OH)D serum concentrations were 10.58 ± 7.68 ng/mL, with 98.7% of subjects having vitamin D below 30 ng/mL and 56.6% with severe deficiency. An inverse correlation was found between 25(OH)D and both CIRS-SI (r: −0.312; p < 0.0001) and CIRS-CI (r: −0.306; p < 0.0001). Independent of multiple covariates an inverse association between both CIRS-SI (p < 0.0001) and CIRS-CI (p < 0.0001) and 25(OH)D was confirmed. Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. An inverse correlation was confirmed between serum 25(OH)D concentrations and CRP (r = −0.142; p = 0.041). CRP, in turn, positively correlated with CIRS-SI (r = 0.209, p = 0.003) and CIRS-CI (r = 0.158, p = 0.023). Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. Conclusions: In hospitalized very old subjects, a higher comorbidity burden is associated with lower 25(OH)D serum levels. Hypovitaminosis D was correlated with higher inflammatory status, which, together with the comorbidities burden, negatively influenced the length of hospital stay. View Full-Text
Keywords: biomarkers; geriatric assessment; hospital-related; multimorbidities; malnutrition; vitamin D biomarkers; geriatric assessment; hospital-related; multimorbidities; malnutrition; vitamin D
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Boccardi, V.; Lapenna, M.; Gaggi, L.; Garaffa, F.M.; Croce, M.F.; Baroni, M.; Ercolani, S.; Mecocci, P.; Ruggiero, C. Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition. Nutrients 2019, 11, 128.

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