Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease.

Abstract. Forli L, Halse J, Haug E, Bjortuft O, VatnM, Kofstad J, Boe J (Rikshospitalet; Clinic ofOsteoporosis; Hormone Laboratory; Aker UniversityHospital; Oslo, Norway). Vitamin D deficiency, bonemineral density and weight in patients withadvanced pulmonary disease. J Intern Med 2004;256: 56–62.Objective. To study the influence of underweight,body composition and vitamin D deficiency on bonemineral density in patients with advancedpulmonary disease.Design. Cross-sectional study with time span forinclusion set at 5 years.Setting. The clinical work and biochemical analyseswere carried out at Rikshospitalet UniversityHospital, Norway. Analyses for vitamin Dmetabolites and bone markers were carried out atAker University Hospital, and bone measurements atClinic of Osteoporosis.Subjects. Seventy-one candidates for lungtransplantation (63% chronic obstructivepulmonary disease, 42 underweight and 29normal weight) were included.Main outcome measures. Body composition, bonemineral density at lumbar spine and femur neck,serum concentration of calcidiol and vitamin Dintake.Results. Subnormal calcidiol levels were present in52% of the underweight patients and 69% of thenormal-weight patients. The resulting models oflinear regression showed that for the lumbar spine Tscores model, the total variation of 16.7% wasexplained by group (underweight/normal weight),sex and age. For the femur neck T scores model, thetotal variation of 20.4% was explained by theinteraction of underweight and vitamin Ddeficiency (with borderline significance) and byarm muscle circumference percentage of standard.In patients with normal calcidiol levels, the medianintake of vitamin D was 17 lg in the underweightpatients and 11 lg in the normal-weight patients.Conclusions. Vitamin D deficiency was common inboth underweight and normal-weight patients, butonly in the underweight patients, an associationbetween vitamin D deficiency and reduced femurneck T scores was indicated.Keywords: body composition, bone mineral density,pulmonary disease, transplantation, vitamin D,weight.