Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes.

Recent evidence suggests that vitamin D intakes above current recommendations may be associated with better health outcomes. However, optimal serum concentrations of 25-hydroxyvitamin D [25(OH)D] have not been defined. This review summarizes evidence from studies that evaluated thresholds for serum 25(OH)D concentrations in relation to bone mineral density (BMD), lower-extremity function, dental health, and risk of falls, fractures, and colorectal cancer.

Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence.

Osteoporotic fractures are an extremely common and serious health problem in the elderly. This article presents the rationale for calcium and vitamin D supplementation in the prevention and treatment of osteoporotic fractures and reviews the literature evidence on the efficacy of this strategy. Two musculoskeletal risk factors are implicated in osteoporotic fractures in the elderly: the loss of bone mass due to secondary hyperparathyroidism and the increased propensity to falls.

Is fall prevention by vitamin D mediated by a change in postural or dynamic balance?

Introduction: The objectives were:(1) to validate a quantitative balance assessment method for fall risk prediction; (2) to investigate whether the effect of vitamin D and calcium on the risk of falling is mediated through postural or dynamic balance, as assessed by this method.

Materials And Methods: A secondary analysis of a double blind randomized controlled trial was employed, which included 64 institutionalized elderly women with complete balance assessment (age range: 65-97; mean 25-hydroxyvitamin D levels: 16.4 ng/ml (SD +/-9.

Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial.

Background: A recent meta-analysis found that cholecalciferol (vitamin D) should reduce falls by more than 20%. However, little is known about whether supplemental cholecalciferol plus calcium citrate malate will lower the long-term risk of falling in men, active older individuals, and older individuals with higher 25-hydroxyvitamin D levels.

Methods: We studied the effect of 3-year supplementation with cholecalciferol-calcium on the risk of falling at least once in 199 men and 246 women 65 years or older and living at home.

Positive association between serum 25-hydroxyvitamin D level and bone density in osteoarthritis.

Objective: To describe the association between serum 25-hydroxyvitamin D (25[OH]D) level and bone mineral density (BMD) in persons with primary knee osteoarthritis (OA).

Methods: We conducted a population-based survey of the Framingham Study. A total of 228 subjects with primary radiographic knee OA were identified.

Improvements in balance after total hip replacement.

We have investigated whether control of balance is improved during stance and gait and sit-to-stand tasks after unilateral total hip replacement undertaken for osteoarthritis of the hip. We examined 25 patients with a mean age of 67 years (sd 6.2) before and at four and 12 months after surgery and compared the findings with those of 50 healthy age-matched control subjects.

Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation.

Background: Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce.

Objective: The purpose of this study was to evaluate the association between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and gingival inflammation.

Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies.

Emerging evidence suggests an inverse relation between vitamin D and blood pressure. We examined the independent association between intake of vitamin D and the risk of incident hypertension among participants of 3 large and independent prospective cohorts: Nurses Health Study I (NHS I; n=77,436), NHS II (n=93,803), and Health Professionals' Follow-up Study (HPFS; n=38,074). Relative risks and 95% confidence intervals for incident hypertension were computed according to quintiles of vitamin D intake using Cox proportional hazards regression and adjusted for relevant covariates.

Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials.

Context: The role and dose of oral vitamin D supplementation in nonvertebral fracture prevention have not been well established.

Objective: To estimate the effectiveness of vitamin D supplementation in preventing hip and nonvertebral fractures in older persons.

Data Sources: A systematic review of English and non-English articles using MEDLINE and the Cochrane Controlled Trials Register (1960-2005), and EMBASE (1991-2005).

A computer touch-screen version of the North American Spine Society outcome assessment instrument for the lumbar spine.

We validated the North American Spine Society (NASS) outcome-assessment instrument for the lumbar spine in a computerised touch-screen format and assessed patients' acceptance, taking into account previous computer experience, age and gender. Fifty consecutive patients with symptomatic and radiologically-proven degenerative disease of the lumbar spine completed both the hard copy (paper) and the computerised versions of the NASS questionnaire. Statistical analysis showed high agreement between the paper and the touch-screen computer format for both subscales (intraclass correlation coefficient 0.

Responsiveness of the electronic touch screen WOMAC 3.1 OA Index in a short term clinical trial with rofecoxib.

Background: The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a self-administered validated questionnaire for patients with osteoarthritis (OA) of the hip or knee. The electronic touch screen version of the WOMAC (e-WOMAC) has been previously shown to be highly correlated with the original paper format. However, whether the e-WOMAC would be suitable for monitoring the effects of drug treatment is unknown.

Psychosocial and geriatric correlates of functional status after total hip replacement.

Objective: To determine whether psychosocial factors, chronic diseases, and common geriatric problems are associated with poor physical function 3 years after primary total hip replacement (THR).

Methods: We studied a sample of Medicare recipients in Ohio, Pennsylvania, and Colorado (n = 922) who underwent primary THR in 1995 (mean +/- SD age 73.1 +/- 5.

Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y.

Background: Vitamin D may improve muscle strength through a highly specific nuclear receptor in muscle tissue.

Objectives: We investigated whether there is an association between 25-hydroxyvitamin D [25(OH)D] concentrations and lower-extremity function in ambulatory older persons, whether that association differs by activity level, and, if so, whether there is an identifiable threshold in the association.

Design: The study was a population-based survey of the ambulatory US population aged 60 to > or =90 y (n = 4100).

Validation and patient acceptance of a computer touch screen version of the WOMAC 3.1 osteoarthritis index.

Objectives: To validate the WOMAC 3.1 in a touch screen computer format, which applies each question as a cartoon in writing and in speech (QUALITOUCH method), and to assess patient acceptance of the computer touch screen version.

Methods: The paper and computer formats of WOMAC 3.

Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population.

Background: Periodontal disease (PD) is a common chronic inflammatory disease and an important risk factor for tooth loss. Vitamin D might affect periodontal disease risk via an effect on bone mineral density (BMD) or via immunomodulatory effects.

Objective: The objective was to evaluate whether serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations are associated with PD in the third National Health and Nutrition Examination Survey.

Effect of Vitamin D on falls: a meta-analysis.

Context: Falls among elderly individuals occur frequently, increase with age, and lead to substantial morbidity and mortality. The role of vitamin D in preventing falls among elderly people has not been well established.

Objective: To assess the effectiveness of vitamin D in preventing an older person from falling.

Vitamin D receptor expression in human muscle tissue decreases with age.

Unlabelled: Intracellular 1,25-dihydroxyvitamin D receptor (VDR) is expressed in human skeletal muscle tissue. However, it is unknown whether VDR expression in vivo is related to age or vitamin D status, or whether VDR expression differs between skeletal muscle groups.

Introduction: We investigated these factors and their relation to 1,25-dihydroxyvitamin D receptor (VDR) expression in freshly removed human muscle tissue.

[Effect of vitamin D on muscle strength and relevance in regard to osteoporosis prevention].

A successful prevention strategy for fractures in the elderly should not be limited to an improvement in bone mineral density. Equally important is the prevention of falls. Thus, 90% of fractures in the elderly are associated with a fall and 30% of all ambulatory, and 50% of institutionalized elderly age 65 years and older fall at least once a year.