Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease

J Intern Med. 2004 Jul;256(1):56-62. doi: 10.1111/j.1365-2796.2004.01337.x.


Objective: To study the influence of underweight, body composition and vitamin D deficiency on bone mineral density in patients with advanced pulmonary disease.

Design: Cross-sectional study with time span for inclusion set at 5 years.

Setting: The clinical work and biochemical analyses were carried out at Rikshospitalet University Hospital, Norway. Analyses for vitamin D metabolites and bone markers were carried out at Aker University Hospital, and bone measurements at Clinic of Osteoporosis.

Subjects: Seventy-one candidates for lung transplantation (63% chronic obstructive pulmonary disease, 42 underweight and 29 normal weight) were included.

Main outcome measures: Body composition, bone mineral density at lumbar spine and femur neck, serum concentration of calcidiol and vitamin D intake.

Results: Subnormal calcidiol levels were present in 52% of the underweight patients and 69% of the normal-weight patients. The resulting models of linear regression showed that for the lumbar spine T scores model, the total variation of 16.7% was explained by group (underweight/normal weight), sex and age. For the femur neck T scores model, the total variation of 20.4% was explained by the interaction of underweight and vitamin D deficiency (with borderline significance) and by arm muscle circumference percentage of standard. In patients with normal calcidiol levels, the median intake of vitamin D was 17 microg in the underweight patients and 11 microg in the normal-weight patients.

Conclusions: Vitamin D deficiency was common in both underweight and normal-weight patients, but only in the underweight patients, an association between vitamin D deficiency and reduced femur neck T scores was indicated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Composition
  • Bone Density*
  • Cross-Sectional Studies
  • Female
  • Femur Neck / physiopathology
  • Humans
  • Lumbar Vertebrae / physiopathology
  • Lung Transplantation
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / surgery
  • Regression Analysis
  • Vitamin D Deficiency / complications*
  • Weight Loss*