BONE MINERAL DENSITY AND VITAMIN D STATUS IN WAR VETERANS AFTER LOWER LIMB AMPUTATION

Abstract

The study aimed to assess bone mineral density (BMD) and vitamin D status in war veterans after unilateral lower limb amputation (ULLA). Methods. In the case-control study, 64 men aged 20–54 years were examined and divided into two groups: healthy subjects without any diseases or conditions affecting bone metabolism (control group) and men who received ULLA (study group). The analysis was performed depending on the presence and level of amputation. BMD was measured by two energy X-ray absorptiometry, and vitamin D status was assessed by serum dihydroxyvitamin D (25(OH)D) levels. Results. Significantly lower BMD values were found in the femoral neck and the hip of t he a mputated ( p = 0 .00002 a nd p = 0.0002, r espectively), byt not in the contralateral side or lumbar spine in amputees compared with controls. Significantly worse BMD indices were found in the femoral neck and the hip in men with transfemoral amputation compared with those with transtibial amputation at the level of the amputation, but not the contralateral side. BMD of the femoral neck of the amputated side significantly correlated with the duration of the post-amputation period (r = –0.47; p = 0.01). Significantly lower serum level of 25(OH) D was found in amputees compared to controls (25.9 ± 4.8) and (32.0 ± 9.8) ng/ml; p = 0.002). 50 % of the control group and 81.25 % of the study group had low side of 25(OH)D. Conclusions. The results demonstrated BMD changes in subjects after ULLA, a significant relationship between BMD and the duration of the post-amputation period, and a high proportion of vitamin D deficiency and insufficiency, which should be taken into account when planning rehabilitation measures in this category of patients.