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Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

Visser, E., de Roos, N. M., Oosting, E., Endenburg, S. C. & Dronkers, J. J., Oct-2018, In : Annals of nutrition and metabolism. 73, 3, p. 252-260 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Edith Visser
  • Nicole M. de Roos
  • Ellen Oosting
  • Silvia C. Endenburg
  • Jaap J. Dronkers

BACKGROUND: Insufficient serum vitamin D concentrations (50-75 nmol/L) are prevalent in 40-65% of patients who require total hip arthroplasty (THA). This could impair physical recovery after surgery. This study investigated the association between preoperative vitamin D status and physical performance after THA. Additionally, postoperative changes in vitamin D concentrations were measured.

METHODS: We included 87 patients scheduled for elective THA and aged ≥65 years. Three groups were recruited: patients classified as vitamin D deficient (< 50 nmol/L, n = 23), insufficient (50-75 nmol/L, n = 32), or sufficient (> 75 nmol/L, n = 32). Serum 25-hydroxyvitamin D3 (25[OH]D3) concentration and physical performance were measured perioperatively. Linear mixed models were used to examine differences between groups.

RESULTS: Change in physical performance over time was not affected by preoperative vitamin D status. In contrast, for physical activity, both vitamin D (p = 0.021) and time (p < 0.001) effect was seen: from 80.2 ± 25.8 to 58.1 ± 17.8 min/day in the deficient group, 143.7 ± 19.8 to 92.9 ± 11.5 min/day in the insufficient group, and 108.1 ± 20.9 to 62.3 ± 12.9 min/day in the sufficient group. The Chair Stand Test, Timed Up and Go test, and 10-Meter Walking Test also improved significantly over time, but independent of vitamin D status. An increase in 25(OH)D3 concentration 6 weeks postoperatively was correlated with improved hip function (Pearson's r = -0.471, p = 0.018). Overall, serum 25(OH)D3 declined with 32% one day after surgery (p < 0.001), to nearly return to baseline values 6 weeks later in all groups.

CONCLUSION: Vitamin D status did not appear to affect physical recovery after THA. The drop in vitamin D after surgery deserves further investigation, but could possibly be explained by hemodilution.

Original languageEnglish
Pages (from-to)252-260
Number of pages9
JournalAnnals of nutrition and metabolism
Volume73
Issue number3
Publication statusPublished - Oct-2018
Externally publishedYes

    Keywords

  • MUSCLE STRENGTH, SKELETAL-MUSCLE, OLDER-ADULTS, D DEFICIENCY, OSTEOARTHRITIS, MOBILITY, POWER, KNEE, SUPPLEMENTATION, METAANALYSIS

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