title: A comparison of biochemical indices of bone turnover in elderly institutionalized and free-living subjects.
abstract: Plasma concentrations of calcium-phosphate, alkaline phosphatase, 25-hydroxyvitamin D (25(OH)D) and albumin, and fasting urinary sodium/creatinine (Na/Cr), calcium/creatinine (Ca/Cr) and hydroxyproline/creatinine (HPr/Cr) were measured in a survey of 208 Chinese elderly subjects living in chronic care institutions, and compared with values from free-living elderly subjects. Plasma parathyroid hormone estimations were also performed on a subpopulation of women living in an institution. Subjects in institutions had higher urinary HPr/Cr ratios in both men and women, as well as higher urinary Ca/Cr ratios in women, suggesting increased bone resorption. These values show significant variation depending on the degree of mobility. Factors which could contribute to the increased bone loss among institutionalized subjects are: reduced physical activity, reduced exposure to sunlight and hence reduced plasma 25(OH)D concentrations, low calcium intake, protein calorie malnutrition and possibly higher sodium intake. Correction of these factors may reduce the risk of fractures among the elderly living in chronic care institutions.
authors.affiliation: Department of Medicine, Chinese University of Hong Kong.
authors.forename: J
authors.initials: J
authors.lastname: Woo
authors.forename: R
authors.initials: R
authors.lastname: Swaminathan
authors.forename: C P
authors.initials: CP
authors.lastname: Pang
authors.forename: Y T
authors.initials: YT
authors.lastname: Mak
authors.forename: D
authors.initials: D
authors.lastname: MacDonald
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000652:urine; D002130:Calcium Phosphates / Q000097:blood; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors; D012964:Sodium / Q000652:urine
chemical_list: D002130:Calcium Phosphates; D012709:Serum Albumin; D012964:Sodium; D003404:Creatinine; D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium