SUMMARY: This prospective study in elderly showed that kidney function plays a minor role in explaining the high prevalence of vitamin D deficiency seen in noninstitutionalized elderly subjects. However, 25-hydroxyvitamin D levels were clearly inversely associated with risk for first fall, which was especially seen in subjects with calcium levels above median. INTRODUCTION: Few prospective studies in elderly exist that have investigated the association of renal dysfunction and vitamin D status on risk of falls. The aim of this study is to evaluate the association of renal function with 25-hydroxyvitamin D (25-OH-D) levels and, secondly, to assess the role of both factors on the risk of falls and subsequent bone fractures. METHODS: This is a prospective population-based cohort study among noninstitutionalized elderly subjects during a 1-year follow-up. 25-OH-D levels and renal function were estimated, the latter by cystatin C-based equations. Information on falls was assessed prospectively. RESULTS: Overall, 1,385 subjects aged 65 and older were included in the study (mean age 75.6 years), of whom 9.2 % had a 25-OH-D serum level above 75 nmol/L (US units 30 ng/mL); 41.4 %, between 50 and 75 nmol/L (US units 20 to 29 ng/mL, insufficiency); and 49.4 %, <50 nmol/L (US units <20 ng/mL, deficiency). We found no association of chronic kidney disease with risk of first fall. In contrast, 25-OH-D serum categories were clearly associated with risk of first fall and we found evidence of effect modification with calcium levels. In the group with a calcium level above the median (≥ 9.6 mg/dL), subjects with 25-OH-D serum level between 50 and 75 nmol/L and with concentrations <50 nmol/L had a hazard rate ratio (HRR) of 1.75 (1.03-2.87) and 1.93 (1.10-3.37) for risk of first fall. 25-OH-D serum levels were also associated with several markers of inflammation and hemodynamic stress. CONCLUSIONS: We demonstrated an association of 25-OH-D serum levels and risk of first fall, which was especially evident in subjects with serum calcium in upper normal, independent of renal function.
SUMMARY: This prospective study in elderly showed that kidney function plays a minor role in explaining the high prevalence of vitamin Ddeficiency seen in noninstitutionalized elderly subjects. However, 25-hydroxyvitamin D levels were clearly inversely associated with risk for first fall, which was especially seen in subjects with calcium levels above median. INTRODUCTION: Few prospective studies in elderly exist that have investigated the association of renal dysfunction and vitamin D status on risk of falls. The aim of this study is to evaluate the association of renal function with 25-hydroxyvitamin D (25-OH-D) levels and, secondly, to assess the role of both factors on the risk of falls and subsequent bone fractures. METHODS: This is a prospective population-based cohort study among noninstitutionalized elderly subjects during a 1-year follow-up. 25-OH-D levels and renal function were estimated, the latter by cystatin C-based equations. Information on falls was assessed prospectively. RESULTS: Overall, 1,385 subjects aged 65 and older were included in the study (mean age 75.6 years), of whom 9.2 % had a 25-OH-D serum level above 75 nmol/L (US units 30 ng/mL); 41.4 %, between 50 and 75 nmol/L (US units 20 to 29 ng/mL, insufficiency); and 49.4 %, <50 nmol/L (US units <20 ng/mL, deficiency). We found no association of chronic kidney disease with risk of first fall. In contrast, 25-OH-D serum categories were clearly associated with risk of first fall and we found evidence of effect modification with calcium levels. In the group with a calcium level above the median (≥ 9.6 mg/dL), subjects with 25-OH-D serum level between 50 and 75 nmol/L and with concentrations <50 nmol/L had a hazard rate ratio (HRR) of 1.75 (1.03-2.87) and 1.93 (1.10-3.37) for risk of first fall. 25-OH-D serum levels were also associated with several markers of inflammation and hemodynamic stress. CONCLUSIONS: We demonstrated an association of 25-OH-D serum levels and risk of first fall, which was especially evident in subjects with serum calcium in upper normal, independent of renal function.
Authors: Dorothea Nitsch; Andrea G Mann; Christopher Bulpitt; Paul J Roderick; Astrid Fletcher Journal: Age Ageing Date: 2011-03-22 Impact factor: 10.668
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: Michael F Holick; Neil C Binkley; Heike A Bischoff-Ferrari; Catherine M Gordon; David A Hanley; Robert P Heaney; M Hassan Murad; Connie M Weaver Journal: J Clin Endocrinol Metab Date: 2011-06-06 Impact factor: 5.958
Authors: Pablo Ureña-Torres; Marie Metzger; Jean Philippe Haymann; Alexandre Karras; Jean-Jacques Boffa; Martin Flamant; François Vrtovsnik; Cédric Gauci; Marc Froissart; Pascal Houillier; Bénédicte Stengel Journal: Am J Kidney Dis Date: 2011-07-31 Impact factor: 8.860
Authors: Allen R Huang; Louise Mallet; Christian M Rochefort; Tewodros Eguale; David L Buckeridge; Robyn Tamblyn Journal: Drugs Aging Date: 2012-05-01 Impact factor: 3.923
Authors: Michael D Denkinger; Sebastian Franke; Kilian Rapp; Gudrun Weinmayr; Enric Duran-Tauleria; Thorsten Nikolaus; Richard Peter Journal: BMC Geriatr Date: 2010-07-27 Impact factor: 3.921
Authors: William B Grant; Sunil J Wimalawansa; Michael F Holick; John J Cannell; Pawel Pludowski; Joan M Lappe; Mary Pittaway; Philip May Journal: Nutrients Date: 2015-02-27 Impact factor: 5.717
Authors: N A Goto; A C G Weststrate; F M Oosterlaan; M C Verhaar; H C Willems; M H Emmelot-Vonk; M E Hamaker Journal: Osteoporos Int Date: 2019-11-12 Impact factor: 4.507