title: Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.
abstract: OBJECTIVE
  To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics.
  
  
  METHODS
  Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined.
  
  
  RESULTS
  In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013).
  
  
  CONCLUSIONS
  The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.
authors.affiliation: Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shinkov
authors.affiliation: Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Borissova
authors.affiliation: Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Lilia
authors.initials: L
authors.lastname: Dakovska
authors.affiliation: Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Jordan
authors.initials: J
authors.lastname: Vlahov
authors.affiliation: Central Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Lidia
authors.initials: L
authors.lastname: Kassabova
authors.affiliation: Central Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Dobrin
authors.initials: D
authors.lastname: Svinarov
authors.affiliation: Department of Hemodialysis, Queen Jovanna Hospital, Medical University of Sofia, Sofia, Bulgaria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Krivoshiev
mesh_terms: D000368:Aged; D002031:Bulgaria / Q000453:epidemiology; D002118:Calcium / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology / Q000209:etiology; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012621:Seasons; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium