Poster 88: Vitamin D Deficiency and Metabolic Bone Disease in Rehabilitation Inpatients

Abstract

Objective: To determine vitamin D status and bone mineral density in patients admitted to a subacute rehabilitation facility. Design: Cross-sectional cohort study. Setting: Subacute rehabilitation facility. Participants: 53 patients admitted from June through February. Intervention: We determined the vitamin D status, bone mineral density, and bone turnover markers. A dietary questionnaire for vitamin D intake was collected. Main Outcome Measures: 25-hydroxyvitamin D (25[OH]D3); bone mineral density, C-telopeptide (CTX), and osteocalcin. Results: Enrolled patients had a mean age of 60.2+14.1, 30 men (56.6%), 23 women (43.4%), 29 white (54.7%), 20 African Americans (37.7%), 2 Hispanic (5.7%), and 1 Asian (1.9%) that was comparable to the demographics of the entire unit over the same period of time. Prevalence of vitamin D deficiency (25[OH]D3 <20ng/mL) was 49.1% (46.7% of men, 52.2% of women) with 41.4% white and 58.3% minority patients affected. The prevalence of osteopenia (T score, <−1) was 52.8% (men, 53.3%; women, 52.2%); osteoporosis (T score, <−2.5) was 17.0% (men, 20.0%; women, 13%). 51.7% of white and 54.2% of minority patients had osteopenia; 6.9% of white and 29.2% of minority patients had osteoporosis. CTX (bone resorption marker) was elevated in 41.5% of patients. Osteocalcin (bone formation marker) was elevated in 11.3% of patients. Measurements of bone resorption and formation positively correlated (R2 =.22) indicating increased bone remodeling. Conclusions: Vitamin D deficiency and osteopenia and osteoporosis was highly prevalent in both men and women admitted for rehabilitation. Elevated bone resorption and remodeling were evident. This could be due to vitamin D deficiency that should be corrected before antiresorptive therapy is considered. The study emphasizes the need for vigilance for vitamin D status and bone mineral density testing in patients admitted to rehabilitation facilities.