%0 Journal Article
%T Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition
%A Carmelinda Ruggiero
%A Francesco Maria Garaffa
%A Lorenzo Gaggi
%A Maria Lapenna
%A Marta Baroni
%A Michele Francesco Croce
%A Patrizia Mecocci
%A Sara Ercolani
%A Virginia Boccardi
%J Archive of "Nutrients".
%D 2019
%R 10.3390/nu11010128
%X 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每30 ng/mL (125每75 nmol/L): optimal range; 30每20 ng/mL (75每50 nmol/L): insufficiency; 20每10 ng/mL (5每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: ˋ0.312; p < 0.0001) and CIRS-CI (r: ˋ0.306; 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 = ˋ0.142; 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
%K biomarkers
%K geriatric assessment
%K hospital-related
%K multimorbidities
%K malnutrition
%K vitamin D
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357065/