Vitamin D, bone mineral density and risk of fracture in people with intellectual disabilities
This is NOT the published version. This is the peer reviewed version of the article, which has been published in final form at https://doi.org/10.1111/jir.12581. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. (427.1Kb)
Andrews, Tim M
Stephenson, Matthew T
Goodwin, Guy M
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Valeria Frighi, Alireza Morovat, Tim M. Andrews, Fareez Rana, Matthew T. Stephenson, Sarah J. White, Emma Fower, Jan Roast, Guy M. Goodwin, 'Vitamin D, bone mineral density and risk of fracture in people with intellectual disabilities', Journal of Intellectual Disability Research (2019). epub ahead of print
Background: People with intellectual disabilities (IDs) have very high rates of osteoporosis and fractures, to which their widespread vitamin D deficiency and other factors could contribute. We aimed to assess in people with IDs previously treated for vitamin D deficiency (1) long‐term adherence to vitamin D supplementation and (2) bone mineral density (BMD), as an indicator for risk of fractures, according to vitamin D supplementation and other factors. Method: We recorded height, weight, medical, pharmacological, dietary and lifestyle assessment. Blood sample were taken for vitamin D and related analytes. dual‐energy X‐ray absorptiometry for BMD was performed. Results: Of 51 study participants (mean [standard deviation, SD] age 51.5 [13.6] years, 57% male), 41 (80.4%) were taking vitamin D and 10 were not. Mean [SD] serum vitamin D was 81.3 [21.3] vs. 25.2 [10.2] nmol/L (P < 0.0001), respectively. Thirty‐six participants underwent a dual‐energy X‐ray absorptiometry scan, which showed osteoporosis in 23.7% and osteopenia in 52.6%. Participants on vitamin D had higher BMD than those who were not, a statistically significant difference when confounders (lack of mobility and hypogonadism) were removed. BMD was significantly different according to mobility, particularly in wheelchair users, in whom hip BMD was 33% lower (P < 0.0001) than in participants with normal mobility. Participants still taking vitamin D showed a 6.1% increase in BMD at the spine (P = 0.003) after mean [SD] 7.4 [1.5] years vitamin D treatment. Conclusions: In people with IDs and previous vitamin D deficiency, BMD increases on long‐term vitamin D supplementation. However, additional strategies must be considered for osteoporosis and fracture prevention in this population.
Published online at https://doi.org/10.1111/jir.12581 Copyright: 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd. Available to eligible users via NHS OpenAthens at https://onlinelibrary.wiley.com/doi/full/10.1111/jir.12581 (login required).