{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:44:19Z","timestamp":1766486659763,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T00:00:00Z","timestamp":1546992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D is a marker of organ diseases is still under debate. We aimed to investigate whether comorbidities were associated with serum 25(OH)D levels in geriatric inpatients. Methods: This is a retrospective study, including 237 subjects consecutively admitted to an acute care geriatric unit, with available data of 25(OH)D serum concentrations. 25(OH)D serum levels were defined according to the following cutoffs: 50\u201330 ng\/mL (125\u201375 nmol\/L): optimal range; 30\u201320 ng\/mL (75\u201350 nmol\/L): insufficiency; 20\u201310 ng\/mL (5\u201325 nmol\/L): deficiency; and &lt;10 ng\/mL (&lt;25 nmol\/L): severe deficiency. Comorbidity was assessed using the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Two summary measures were obtained, the Illness Severity Index (CIRS-SI) and the Comorbidity Index (CIRS-CI). Results: 177 (74.68%) women and 60 (25.32%) men with mean age of 85 \u00b1 6 years old were enrolled. The majority of subjects (68.6%) were at risk of malnutrition. Overall, the burden of comorbidity was 1.87 \u00b1 1.33 for CIRS-CI and 1.18 \u00b1 0.40 for CIRS-SI. 25(OH)D serum concentrations were 10.58 \u00b1 7.68 ng\/mL, with 98.7% of subjects having vitamin D below 30 ng\/mL and 56.6% with severe deficiency. An inverse correlation was found between 25(OH)D and both CIRS-SI (r: \u22120.312; p &lt; 0.0001) and CIRS-CI (r: \u22120.306; p &lt; 0.0001). Independent of multiple covariates an inverse association between both CIRS-SI (p &lt; 0.0001) and CIRS-CI (p &lt; 0.0001) and 25(OH)D was confirmed. Both CIRS-SI (r = 0.251, p &lt; 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. An inverse correlation was confirmed between serum 25(OH)D concentrations and CRP (r = \u22120.142; p = 0.041). CRP, in turn, positively correlated with CIRS-SI (r = 0.209, p = 0.003) and CIRS-CI (r = 0.158, p = 0.023). Both CIRS-SI (r = 0.251, p &lt; 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. Conclusions: In hospitalized very old subjects, a higher comorbidity burden is associated with lower 25(OH)D serum levels. Hypovitaminosis D was correlated with higher inflammatory status, which, together with the comorbidities burden, negatively influenced the length of hospital stay.<\/jats:p>","DOI":"10.3390\/nu11010128","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T03:22:31Z","timestamp":1547090551000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-1122","authenticated-orcid":false,"given":"Virginia","family":"Boccardi","sequence":"first","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Lapenna","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Gaggi","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco Maria","family":"Garaffa","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele Francesco","family":"Croce","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Baroni","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ercolani","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0729-5246","authenticated-orcid":false,"given":"Patrizia","family":"Mecocci","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-1963","authenticated-orcid":false,"given":"Carmelinda","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, 06123 Perugia PG, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. 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