Men's Osteoporosis Support GroupVitamin D's relation to disease mortality and cystic fibrosis and osteoporosis Eur J Clin Nutr. 2009 Dec 2. [Epub ahead of print]. Relationship of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality in older community-dwelling adults. Semba RD, and others. PMID: 19953106. This study followed 1006 community-dwelling adults age 65 or older in Tuscany, Italy. 25(OH)D (vitamin D) was measured at the beginning of the study which followed the participants' mortality for 6.5 years. They found that 228 died, 107 from cardiovascular diseases. Those in the lowest quartile of serum 25(OH)D were more than twice as likely to die of all-cause mortality compared to those in the highest quartile. Cardiovascular mortality was 2.6 times higher in the lowest quartile compared to the highest. The authors concluded, "Older community-dwelling adults with low serum 25(OH)D levels are at higher risk of all-cause and cardiovascular disease mortality" Editor's comments. There is an Update that discusses the multiple conditions that vitamin D has effects on, not just bone mineralization. Included in the list are high blood pressure and heart disease. The Semba article confirms the relationship of low serum 25(OH)D to both all-cause mortality and that from cardiovascular diseases. It is likely that low 25(OH)D is just one symptom of lack of outdoor activity and inadequate nutrition, other probably factors in the mortality of participants. Although the authors say they adjusted for other confounders. I had my serum 25(OH)D tested last month and it was a bit low, which surprised me. I spend a lot of time in the sun during the summer, and some, but not nearly as much in the fall and winter, and I've been taking the high-potency vitamin D supplements, 2,000 I.U. 3 times/week. I just checked the print out and realize they didn't give the units of measure for the test. Two different ones are used: ng/ml or nmol/l, which is 2.496 times ng/ml. I just assumed the test was done with ng/ml, but now I realize I need to have that confirmed. The recorded result was 29. If that is ng/ml, it is slightly low. If it is nmol/l, then it is very low. There is a recent Update where Heaney is suggesting that 80 nmol/l or higher is ideal. Also note this Update discusses vitamin D3 as being superior to vitamin D2 for supplementation purposes. Also see this Update for more details on using vitamin D3. After getting this result I have upped the vitamin D3 to once-daily dosing. So, particularly for the elderly, it behooves us to keep tabs on our serum vitamin D levels. I would suggest discussing with your care provider having testing done at least annually and then adjust supplement intake accordingly when you get the result. Be sure you know the units of measurement used for the test. Calcif Tissue Int. 2009 Dec 1. [Epub ahead of print]. The Prevalence of Osteoporosis, Osteopenia, and Fractures Among Adults with Cystic Fibrosis: A Systematic Literature Review with Meta-Analysis. Paccou J and others. PMID: 19949942. This is a meta-analysis of literature regarding the prevalence of osteoporosis, osteopenia and fractures in adults with cystic fibrosis. In summary, after their review of the literature that included 1055 adults, the authors found a 23.5% incidence of osteoporosis, 38% had osteopenia, and 14% had vertebral fractures while 19.7% had non-vertebral fractures. They noted, "In conclusion, this systematic literature review with meta-analysis emphasized the high prevalence of osteopenia and osteoporosis in young adults with cystic fibrosis. The prevalence of fracture was also high." Editor's comments. This is a very high rate of osteoporosis, osteopenia and fractures in young adults aged less than 32 years. Another abstract suggests the following causes of low bone mineral density (BMD) for young adults with cystic fibrosis: "Prevention and treatment of CF-related bone disease must address the myriad risk factors (decreased absorption of fat-soluble vitamins due to pancreatic insufficiency, altered sex hormone production, chronic lung infection with increased serum levels of proinflammatory, bone-active cytokines, malnutrition and low body weight, physical inactivity and glucocorticoid therapy) for poor bone health." See Curr Opin Endocrinol Diabetes Obes. 2009 Dec;16(6):407-14. 'Old' bones in young bodies: the tale of cystic fibrosis. Sparks AA and others. PMID: 19816169. Another recent study found 76% of young adults with cystic fibrosis were deficient in serum vitamin D, another risk factor for low BMD. This should be correctable with supplements and/or sunshine. See Clin Endocrinol (Oxf). 2008 Sep;69(3):374-81. Epub 2008 Feb 11. Vitamin D and bone health in adults with cystic fibrosis. Wolfenden L and others. PMID: 18284636. Thus individuals diagnosed with cystic fibrosis should ask to be examined and followed by an endocrinologist or other practitioner specializing in osteoporosis. This both for preventive and treatment considerations regarding bone health. Those with cystic fibrosis don't want to be dealing with fractures along with their lung and other problems.
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