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Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients.

Abstract：

PURPOSE:Adverse drug reactions as well as vitamin D deficiency are issues of public health concern in older people. However, relatively little is known about the impact of drug use on vitamin D status. Our primary aim is to explore associations between drug use and vitamin D status in older people. Furthermore, prevalences of drug use and vitamin D deficiency are estimated. METHODS:In a population of 873 community-dwelling Dutch geriatric outpatients, we explored the cross-sectional relationships of polypharmacy (≥5 medications concomitantly used), severe polypharmacy (≥10 medications), and use of twenty-one specific drug groups, with serum 25-hydroxyvitamin D (25(OH)D) by analysis of covariance. RESULTS:Overall prevalence of polypharmacy was 65 %, of severe polypharmacy 22 %. Depending on the cut-off value, prevalence of vitamin D deficiency was 49 % (<50 nmol/l) or 77 % (<75 nmol/l). Of the patients using a vitamin D supplement, 17 % (<50 nmol/l) or 49 % (<75 nmol/l) were still deficient. In non-users of supplemental vitamin D, after adjustment for age and gender, negative associations were found for severe polypharmacy, metformin, sulphonamides and urea derivatives (SUDs), vitamin K antagonists, cardiac glycosides, loop diuretics, potassium-sparing diuretics, ACE inhibitors, and serotonin reuptake inhibitors; for non-selective monoamine reuptake inhibitors (NSMRIs) the association was positive. The most extreme impacts of drug use on adjusted mean 25(OH)D were -19 nmol/l for SUDs and +18 nmol/l for NSMRIs. CONCLUSION:Drug use should be considered a risk factor for vitamin D deficiency amongst geriatric outpatients.

journal_name

Eur J Clin Pharmacol

journal_title

European journal of clinical pharmacology

authors

van Orten-Luiten AC,Janse A,Dhonukshe-Rutten RA,Witkamp RF

doi

10.1007/s00228-016-2016-2

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

605-14

issue

5

eissn

0031-6970

issn

1432-1041

pii

10.1007/s00228-016-2016-2

journal_volume

72

pub_type

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