OBJECTIVE: To investigate via the vitamin D status whether patients with peripheral arterial disease (PAD) tend to develop vitamin D deficiency that in turn influences their clinical symptoms. DESIGN: Cross-sectional. SETTING: University hospital. PATIENTS AND PARTICIPANTS: Three hundred twenty-seven patients were evaluated; subjects with secondary causes of bone disease or bone active medication were excluded. One hundred sixty-one patients with either PAD stage II (n = 84) or stage IV (n = 77) were enrolled and compared to 45 age- and sex-matched healthy controls. MEASUREMENTS AND MAIN RESULTS: All patients underwent determinations of serum chemistry, 25-hydroxyvitamin D (vitamin D3) intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and osteocalcin and were further stratified according to an individual restriction score into 3 groups: mildly, moderately, or severely restricted in daily life due to the underlying disease. Patients with PAD IV showed significantly lower vitamin D3 (P =.0001), and calcium (P =.0001) values and significantly higher iPTH (P =.0001), osteocalcin (P =.0001) and ALP (P =.02) levels as compared to patients with PAD II. Patients considering themselves as severely restricted due to the underlying disease showed lower vitamin D3 and higher iPTH levels than those who described only a moderate (vitamin D3: P <.001; iPTH: P <.01) or mild (vitamin D3: P <.001; iPTH: P <.001) restriction in daily life. CONCLUSION: Patients with PAD IV, especially those who feel severely restricted due to the disease, are at high risk of developing vitamin D deficiency, secondary hyperparathyroidism, and ultimately osteomalacia due to immobilization and subsequent lack of exposure to sunlight, all of which in turn lead to further deterioration. Monitoring of vitamin D metabolism and vitamin D replacement therapy could be a simple, inexpensive approach to mitigating clinical symptoms and improving quality of life in patients with advanced PAD.
OBJECTIVE: To investigate via the vitamin D status whether patients with peripheral arterial disease (PAD) tend to develop vitamin D deficiency that in turn influences their clinical symptoms. DESIGN: Cross-sectional. SETTING: University hospital. PATIENTS AND PARTICIPANTS: Three hundred twenty-seven patients were evaluated; subjects with secondary causes of bone disease or bone active medication were excluded. One hundred sixty-one patients with either PAD stage II (n = 84) or stage IV (n = 77) were enrolled and compared to 45 age- and sex-matched healthy controls. MEASUREMENTS AND MAIN RESULTS: All patients underwent determinations of serum chemistry, 25-hydroxyvitamin D (vitamin D3) intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and osteocalcin and were further stratified according to an individual restriction score into 3 groups: mildly, moderately, or severely restricted in daily life due to the underlying disease. Patients with PAD IV showed significantly lower vitamin D3 (P =.0001), and calcium (P =.0001) values and significantly higher iPTH (P =.0001), osteocalcin (P =.0001) and ALP (P =.02) levels as compared to patients with PAD II. Patients considering themselves as severely restricted due to the underlying disease showed lower vitamin D3 and higher iPTH levels than those who described only a moderate (vitamin D3: P <.001; iPTH: P <.01) or mild (vitamin D3: P <.001; iPTH: P <.001) restriction in daily life. CONCLUSION:Patients with PAD IV, especially those who feel severely restricted due to the disease, are at high risk of developing vitamin D deficiency, secondary hyperparathyroidism, and ultimately osteomalacia due to immobilization and subsequent lack of exposure to sunlight, all of which in turn lead to further deterioration. Monitoring of vitamin D metabolism and vitamin D replacement therapy could be a simple, inexpensive approach to mitigating clinical symptoms and improving quality of life in patients with advanced PAD.
Authors: H Glerup; K Mikkelsen; L Poulsen; E Hass; S Overbeck; H Andersen; P Charles; E F Eriksen Journal: Calcif Tissue Int Date: 2000-06 Impact factor: 4.333
Authors: V G Chel; M E Ooms; C Popp-Snijders; S Pavel; A A Schothorst; C C Meulemans; P Lips Journal: J Bone Miner Res Date: 1998-08 Impact factor: 6.741
Authors: M C Chapuy; M E Arlot; F Duboeuf; J Brun; B Crouzet; S Arnaud; P D Delmas; P J Meunier Journal: N Engl J Med Date: 1992-12-03 Impact factor: 91.245
Authors: Songcang Chen; Christopher S Law; Christopher L Grigsby; Keith Olsen; Ting-Ting Hong; Yan Zhang; Yerem Yeghiazarians; David G Gardner Journal: Circulation Date: 2011-09-26 Impact factor: 29.690
Authors: Astrid Fahrleitner-Pammer; Andrea Obernosterer; Ernst Pilger; Harald Dobnig; Hans Peter Dimai; Georg Leb; Stefan Kudlacek; Barbara M Obermayer-Pietsch Journal: Osteoporos Int Date: 2004-07-31 Impact factor: 4.507
Authors: Aaron R Folsom; Alvaro Alonso; Jeffrey R Misialek; Erin D Michos; Elizabeth Selvin; John H Eckfeldt; Josef Coresh; James S Pankow; Pamela L Lutsey Journal: Am Heart J Date: 2014-06-09 Impact factor: 4.749
Authors: José Luis Pérez-Castrillón; Laura Abad Manteca; Gemma Vega; Javier Del Pino Montes; Daniel de Luis; Antonio Duenas Laita Journal: Int J Endocrinol Date: 2009-08-19 Impact factor: 3.257