維生素D可增加髖部骨折後走路的機會 Vitamin D boosts chances of walking after hip fracture

News Release 17-Mar-2020

Scientists studied the impact of vitamin D on post-surgery mobility

Rutgers University

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IMAGE: Senior citizens who are not vitamin D deficient have a better chance of walking after hip fracture surgery, according to a Rutgers-led study. The findings in The American Journal of… view more  Credit: Sue Shapses/Rutgers University-New Brunswick

Senior citizens who are not vitamin D deficient have a better chance of walking after hip fracture surgery, according to a Rutgers-led study.

The findings in The American Journal of Clinical Nutrition suggest that vitamin D deficiency could limit mobility in older adults, said senior author Sue Shapses, a professor in the Department of Nutritional Sciences at the School of Environmental and Biological Sciences at Rutgers University-New Brunswick.

Shapses suggests that older adults take 800 international units (IU), equivalent to 20 micrograms, of vitamin D daily to prevent deficiency. Vitamin D is important for bone health, and people get it through some foods, exposure to the sun and vitamin pills.

“An important next step is learning how vitamin D affects mobility,” said Shapses, who is also an adjunct professor in the Department of Medicine at Rutgers Robert Wood Johnson Medical School and director of the Center for Human Nutrition, Exercise and Metabolism at Rutgers’ New Jersey Institute for Food, Nutrition, and Health. “For example, it is not clear if severe vitamin D deficiency is associated with direct effects on muscle, cognition and/or other organ systems.”

A broken hip – among the most serious fall injuries – is hard to recover from, with many people unable to live on their own afterward. In the United States, more than 300,000 people 65 or older are hospitalized for hip fractures annually and falling causes more than 95 percent of these type of fractures. Women fall more frequently than men, experiencing three-quarters of hip fractures, and the number of fractures is likely to rise as the population ages, according to the U.S. Centers for Disease Control and Prevention.

Regaining mobility after a hip fracture is important for full recovery and to reduce the risk of death. But vitamin D deficiency is associated with reduced mobility after surgery to repair a hip fracture.

The multi-site study of patients 65 or older in the United States and Canada examined the influence of vitamin D levels in blood serum and nutrition on mobility. The study focused on death rate or inability to walk 10 feet (or across a room) without someone’s help after surgery.

The findings showed that vitamin D levels greater than 12 nanograms per milliliter (12 parts per billion) in blood serum are associated with a higher rate of walking at 30 and 60 days after hip fracture surgery. While poor nutrition is associated with reduced mobility 30 days after surgery, that factor was not statistically significant. Still, in patients with high levels of parathyroid hormone, which leads to high levels of calcium in blood, mobility was reduced if their nutritional status was poor.

“This matters because vitamin D deficiency and malnutrition are common disorders in elderly patients with hip fractures and often occur together since both are complications of poor nutrition,” Shapses said.

Previous studies have shown that taking 800 IU of vitamin D a day can prevent falling and fractures. A Rutgers-led study published last year indicated that high vitamin D intake (4,000 IU a day) compared with 600 IU a day may reduce reaction time, potentially boosting the risk of falling and fractures. The recommended dietary allowance for vitamin D is 600 IU daily for people from 1 to 70 years old and 800 for people over 70.

“These studies suggest that too much or too little vitamin D will affect mobility and falls in the elderly,” Shapses said.

The lead author is Lihong Hao, a post-doctoral associate in the Department of Nutritional Sciences. Co-authors include Jeffrey L. Carson, provost, New Brunswick at Rutgers Biomedical and Health Sciences and Distinguished Professor of Medicine and Richard C. Reynolds M.D. chair in General Internal Medicine at Rutgers Robert Wood Johnson Medical School; Yvette Schlussel, research scientist and statistician in the Department of Nutritional Sciences; and Helaine Noveck at Rutgers Robert Wood Johnson Medical School.

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維生素D可增加髖部骨折後走路的機會

新聞稿2020年3月17日
維生素D可增加髖部骨折後走路的機會
科學家研究了維生素D對手術後流動性的影響
羅格斯大學

圖片:根據羅格斯(Rutgers)領導的一項研究,髖部骨折手術後沒有維生素D缺乏的老年人有更好的步行機會。 《美國日報》的發現…查看更多
圖片來源:Sue Shapses /羅格斯大學-新不倫瑞克省
Rutgers領導的一項研究表明,沒有維生素D缺乏的老年人在髖部骨折手術後更容易走路。

羅格斯大學新不倫瑞克分校環境與生物科學學院營養科學系教授蘇·夏普斯說,《美國臨床營養學雜誌》的發現表明維生素D缺乏會限制老年人的活動能力。
簡報顯示,老年人每天服用800國際單位(IU)維生素D,相當於20微克,以防止缺乏。維生素D對骨骼健康很重要,人們通過一些食物,日曬和維生素藥丸獲得維生素D。

肖普斯說:“下一步重要的工作就是學習維生素D如何影響運動能力,”夏普斯說,他也是羅格斯大學羅伯特伍德·約翰遜醫學院的醫學系兼職教授,也是羅格斯大學人類營養,運動和代謝中心的主任。新澤西州食品,營養與健康研究所。 “例如,尚不清楚嚴重的維生素D缺乏症是否與對肌肉,認知和/或其他器官系統的直接影響有關。”

髖部骨折-最嚴重的跌落傷害-很難恢復,許多人此後無法獨自生活。在美國,每年有30萬65歲或65歲以上的人因髖部骨折而住院,跌倒造成此類骨折的比例超過95%。根據美國疾病控制和預防中心的數據,女性跌倒的頻率比男性高,發生四分之三的髖部骨折,並且骨折的人數可能隨著人口的老齡化而增加。
髖部骨折後恢復活動性對於全面康復和降低死亡風險很重要。但是維生素D缺乏症與修復髖部骨折術後的活動能力降低有關。

在美國和加拿大對65歲或65歲以上的患者進行的多站點研究研究了血清和營養中維生素D水平對運動性的影響。該研究的重點是死亡率或在手術後沒有他人幫助的情況下無法走10英尺(或跨過房間)的情況。

研究結果表明,髖部骨折手術後30天和60天,血清中維生素D含量高於每毫升12毫微克(12億分之12)與較高的步行率相關。營養不良與術後30天行動不便相關,但該因素在統計學上並不顯著。但是,在甲狀旁腺激素水平高,導致血液中鈣水平高的患者中,如果營養狀況不佳,則會降低活動能力。

Shapses說:“這很重要,因為維生素D缺乏症和營養不良是老年髖部骨折患者的常見疾病,並且由於營養不良而常常並發,因此經常一起發生。”

先前的研究表明,每天服用800 IU的維生素D可以預防跌倒和骨折。去年發表於羅格斯(Rutgers)領導的一項研究表明,高維生素D攝入量(每天4,000 IU)與每天600 IU相比,可減少反應時間,從而可能增加跌倒和骨折的風險。對於1至70歲的人,維生素D的建議飲食津貼為每天600 IU,對於70歲以上的人,維生素D的建議飲食津貼為800 IU。

夏普斯說:“這些研究表明,維生素D過多或過少都會影響老年人的活動能力並使其跌倒。”

主要作者是營養科學系博士後助理郝麗紅。合著者包括羅傑斯生物醫學與健康科學學院的普倫斯特省教務長杰弗裡·L·卡森(Jeffrey L. Carson),羅格斯大學羅伯特伍德·約翰遜醫學院羅伯特·伍德·約翰遜醫學院的普通內科醫學教授理查德·雷諾茲醫學博士。營養科學系研究科學家兼統計學家Yvette Schlussel;羅格斯·羅伯·伍德·約翰遜醫學院的Helaine Noveck和Helaine Noveck。

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