Article

OBJECTIVE: To investigate whether muscle mass mediates the significant
association between vitamin D status and functional recovery after hip fracture
in women. DESIGN: Observational study. SETTING: Rehabilitation hospital in Italy.
PARTICIPANTS: We investigated white women (N=280) of 305 who were consecutively
admitted to a rehabilitation hospital because of their first fracture of the hip.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: To assess muscle mass, we
measured appendicular lean mass (aLM) by dual-energy x-ray absorptiometry (DXA),
21.2+/-6.2 (mean +/- SD) days after hip fracture occurrence in the 280 women. On
the same day, we assessed serum levels of 25-hydroxyvitamin D and parathyroid
hormone (PTH). Ability to function in activities of daily living was evaluated by
the Barthel Index both before and after acute inpatient rehabilitation. RESULTS:
After adjustment for 8 confounders, including age, cognitive impairment, pressure
ulcers, neurologic impairment, infections, fracture type, Barthel Index score at
admission to rehabilitation, and aLM/height(2) (aLM/ht(2)), 25-hydroxyvitamin D
levels were significantly associated both with Barthel Index scores after
rehabilitation (P=.003) and their changes during rehabilitation (P=.008). Similar
results were obtained when the 25-hydroxyvitamin D/PTH ratio was substituted for
25-hydroxyvitamin D levels. Conversely, aLM/ht(2) was not significantly
correlated with Barthel Index scores and their changes during rehabilitation.
Furthermore, we found no significant associations between either
25-hydroxyvitamin D levels or the 25-hydroxyvitamin D/PTH ratio and aLM/ht(2).
CONCLUSIONS: The significant association between 25-hydroxyvitamin D levels (and
25-hydroxyvitamin D/PTH ratio) and the ability to function in women with hip
fractures was not mediated by aLM assessed by DXA.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
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Langue : ANGLAIS