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- Open Access
High bone turnover in critically vitamin-D-deficient patients
© Amrein et al. 2011
- Published: 1 March 2011
- Bone Loss
- Bone Turnover
- Increase Bone Resorption
Vitamin D deficiency, hypocalcemia and acute immobilization negatively affect bone metabolism and are present in the majority of critically ill patients. Although high bone turnover is highly prevalent in the ICU and might compromise long-term outcome, there are currently no data on fracture risk after critical illness.
We assessed bone turnover comparing placebo (P) with a cholecalciferol loading dose (VITD) over a 1-week observation period in critically ill medical patients with vitamin D deficiency (25(OH)D ≤20 ng/ml). Markers of bone and mineral metabolism (β-CTx, 0.06 to 0.35 ng/ml, C-terminal telopeptide of type I collagen; OC, osteocalcin, 1.0 to 35.0 ng/ml) were analysed. Analyses were repeated at days 3 and 7 after 540,000 IU cholecalciferol or matched placebo were given enterally.
Biochemical markers of bone turnover (7-day observation)
Increased bone resorption is frequent in patients in the medical ICU. Intravenous bisphosphonates have been suggested to mitigate bone loss in patients at risk; however, correction of vitamin D deficiency might be a prerequisite for optimal efficacy in this vulnerable population.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.