Study on critical illness and bone turnover

Abstract

Purpose: Critical illness has been recognized to acutely influence bone metabolism and, consequently, bone mineral density. The main purpose of this study was to describe bone metabolism changes in adult survivors of critical illness in an attempt to correlate them with severity scores. Methods: An open, prospective, observational, monocentric study in patients admitted to the intensive care unit (ICU) was conducted, evaluating bone metabolism at baseline (within 72 hours of ICU admission), 6 months, and 12 months. Results: Fifty-nine patients admitted to the ICU (63% males), mean age 58 ± 16 years, were enrolled. Of these, 20 patients (34%) completed the one-year follow up. At baseline, bone resorption showed an increase, which was maintained at 6 months, and followed by normalization at 12 months. Patients showed, in the majority of cases, hypovitaminosis D with hyperparathyroidism at baseline with subsequent normalization. A trend towards a correlation was described between severity scores and serum 25(OH) vitamin D and bone turnover marker levels. Conclusions: These results help to confirm a positive association between critical illness requiring ICU admission and bone metabolism changes. This study lays the foundations for further studies evaluating bone health in ICU patients. KEY WORDS: Critical illness, osteoporosis, bone turnover, bone metabolism, treatment.