Article

CONTEXT: Vitamin D status and parathyroid hormone (PTH) levels influence the risk
of accidental falls in older people, but the mechanisms underlying this effect
remain unclear. OBJECTIVE: Investigate the relationship between circulating PTH
and 25 hydroxyvitamin D (25-OHD) levels and clinical tests of gait stability and
balance as physical fall risk factors. We hypothesized that high levels of PTH
and low 25-OHD levels would be significantly associated with gait stability and
decreased balance performance. DESIGN: Observational cohort study. SETTING:
Australian community. PARTICIPANTS: 119 healthy, ambulatory female twin adults
aged 47-80 years residing in Victoria, Australia. OUTCOME MEASURES: Serum PTH and
25-OHD levels with clinical tests of gait stability [double support duration
(DSD)] and dynamic balance (Step Test). Associations were investigated by
regression analysis and by comparing groups divided by tertiles of PTH (<3.5,
3.5-4.9, >4.9pmol/L) and 25-OHD (<53, 53-75, >75 nmol/L) using analysis of
variance. RESULTS: Serum PTH was associated positively with DSD, with an increase
of 10.6-15.7% when the mid and highest PTH tertiles were compared to the lowest
tertile (p <0.025) when 25-OHD was included in the regression analysis. 25-OHD
was significantly associated with DSD (greater by 10.6-11.1% when lowest and
mid-tertiles compared with the highest 25-OHD tertile) (p <0.025) and dynamic
balance (better performance by 12.6% in the highest compared with the lowest
25OHD tertile) (p <0.025). CONCLUSION: These findings reveal an important new
relationship between parathyroid hormone and gait stability parameters and add to
understanding of the role of 25-OHD in motor control of gait and dynamic balance
in community-dwelling women across a wide age span.
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Langue : ANGLAIS