Carotid intima-media thickness is not associated with vitamin D and PTH levels in patients admitted to an Internal Medicine Department.

Vitamin D (25OHD) and/or parathyroid hormone (PTH) levels have been associated with common carotid intima-media thickness (IMT). We investigated such associations in inpatients consecutively admitted to an Internal Medicine Department. In 168 consecutive patients admitted to our department, 25 hydroxyvitamin D (25OHD) was measured by means of RIA and PTH by means of ICMA, whereas IMT by means of ultrasonography. The main cardiovascular risk factors were also explored. In patients with either diabetes, or hypertension, or both, 25OHD values were not significantly lower than in other patients. No difference was found among the IMT values across tertiles of 25OHD level, as like as in the 25OHD, PTH, PTH/25OHD ratio values of patients either grouped by tertiles of IMT, or categorized according to IMT of <0.9, 0.9-1.5, and >1.5 mm. IMT did not significantly associate with 25OHD, PTH, and PTH/25OHD ratio, whereas it positively associated with age (r = 0.281; p < 0.001) and BMI (r = 0.138; p = 0.074), and negatively with eGFR (r = -154; p = 0.046). Multiple regression models showed that IMT was significantly associated to age and BMI, while 25OHD, PTH, or PTH/25OHD ratio did not increase the significance of the models. IMT assessment does not seem to be associated with 25OHD and PTH levels in unselected inpatients.

Assessment of fracture risk by the FRAX algorithm in men and women with and without type 2 diabetes mellitus: a cross-sectional study.

BACKGROUND: The FRAX algorithm is a diffuse tool to assess fracture risk, but it has not been clinically applied in European patients with diabetes. We investigated FRAX-estimated fracture risk in patients with type 2 diabetes mellitus (DM), compared with concomitantly enrolled control subjects. METHODS: In our multicentric cross-sectional study, we assessed the FRAX scores of 974 DM and 777 control subjects from three Italian diabetes outpatient clinics, and in DM. We tested the association between parameters and complications of the disease and FRAX scores. RESULTS: DM had significantly lower FRAX-estimated probability of both major osteoporotic fracture (MOF) and hip fracture (HF) than control subjects (6.35 ± 5.07% versus 7.75 ± 6.93%, p < 0.001, and 2.17 ± 3.07% versus 2.91 ± 4.56%, p = 0.023, respectively). When grouping by gender, such differences were found only in men. In DM, the frequency of previous fracture was higher than in control subjects (29.88% versus 20.46%, p < 0.001). In diabetic patients, age, sex, body mass index, HbA1c and hypoglycaemia are significantly associated with FRAX scores; gender-specific regression models differed. Among DM, the tree-based regression (classification and regression tree (CART)) analysis identified groups of patients with different mean FRAX scores. In female DM aged > 65 years with or without obesity, MOF > 20% was found in 5.66% and 13.53% and H > 3% in 40.57% and 63.91% of patients, respectively. CONCLUSIONS: Patients with DM had mean FRAX scores lower than control subjects, despite the higher number of previous fractures. Some features and complications of DM did associate with FRAX scores. Among DM patients, the CART analysis identified subgroups with higher FRAX scores. However, despite its potential utility, concerns still remain for using FRAX in DM patients.

Vitamin D status in inpatients admitted to an internal medicine department.

BACKGROUND/AIMS: A role of hypovitaminosis D has been advocated in several medical conditions. We investigated vitamin D status in medical inpatients, compared to a blood donors' group from the same area. METHODS: Fifty-nine consecutive medical patients were recruited at hospital admission, concomitantly to 207 blood donors of both genders. Serum calcium, albumin, phosphate, creatinine, alkaline phosphatase total activity, 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) were assessed from April to May 2005. RESULTS: In patients, 25(OH)D values were lower (13.1 +/- 9.2 vs. 16.3 +/- 8.5 ng/ml; p < 0.02) and PTH values higher (73.9 +/- 77.7 vs. 53.4 +/- 24.3 pg/ml; p < 0.01) than in controls, whose mean age was lower (62.5 +/- 14.5 vs. 45.8 +/- 15.6 years, p < 0.01). Such differences were not confirmed when comparing patients to a subgroup of age and sex-matched controls drawn from the whole sample of blood donors. In both patients and controls there was a trend towards a negative correlation between 25(OH)D and age and a positive correlation between PTH and age. The prevalence of 25(OH)D <12 ng/ml was higher in patients than in controls as a whole (58 vs. 34%; chi(2) = 9.95; p < 0.002), but not in respect to the subgroup of matched controls (58 vs. 44%; chi(2) = 2.09; p = 0.14). The prevalence of severe vitamin D deficiency, 25(OH)D <5 ng/ml, was significantly higher in patients than in matched controls (17 vs. 4%; chi(2) = 6.75; p < 0.01). CONCLUSION: Hypovitaminosis D, defined as 25(OH)D <12 ng/ml, is frequent among inpatients, as in the general population of comparable age. A severe vitamin D deficiency is more common in hospitalized patients.