Prevalence of vitamin D deficiency in patients with spinal cord injury: a cross sectional study.
1Gainullina I, 1Rouse A, 2Hirani S, 1Saif M, 1Graham A, 1Wong S
1National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, , United kingdom; 2City, University of London, London, , United kingdom
Introduction / Objectives: Previous studies reported that the prevalence of hypovitaminosis D is increased amongst spinal cord injured (SCI) individuals.1 This could possibly due to decreased mobility, prolonged institutionalisation and reduced exposure to sunlight following SCI. Hypovitaminosis D can be influenced by factors such the seasons. Methods: This study aimed to (1) evaluate 25-hydroxyvitamin D concentrations in SCI patients admitted to a UK SCI centre over four seasons and (2) to assess the characteristics of vitamin D deficiency in this patient group.
Results: 416 adults (mean age: 51.6 years, 85.8% Caucasian, 24.8% female) with SCI (55.1% tetraplegia; 45.3% complete SCI) were studied prospectively during April 2012 to June 2015. Data was collected by two trained researchers from individual patient notes using a standardised questionnaire. Vitamin D levels (nmol/l) <25; < 50; <80 and >80 were defined as severe deficient; deficient; insufficient and normal, respectively. Almost all (90.9%) SCI patients were vitamin D insufficient, 64.2% had vitamin D deficiency and 15.6% were severe deficient. Hypovitaminosis D (<50 nmol/L) was associated with undernutrition risk2 (p<0.01) and, non-summer seasons (p<0.01). Hypovitaminosis D was found to be less common in summer when compared to Autumn, Winter and Spring. (47.8%, 62.3%, 69.6%, 73.8%, p<0.01)
Conclusion: The present study shows hypovitaminosis D is common. Strategies for systematic screening, efficacy and safety of vitamin D supplementation in SCI population need to be reviewed. Given the severe loss of quality of life for these patients, a cost-effective, reliable therapy would appear to be highly desirable. Further study of the efficacy of vitamin D supplementation on bone mineral density and body composition in SCI patients is warranted.
1. Zafeiris et al (2012) Spine J 12, 304-312;
2. Wong S et al (2012) Eur J Clin Nutr 66, 382-387.
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