The association between critical illness and changes in bone turnover in adults: a systematic review

Abstract

A positive association between critical illness requiring intensive care admission and bone turnover exists, although data are limited, and the risk factors and the nature of the relationship are not yet understood. Prospective cohort studies that identify risk factors and extent of critical illness related bone turnover changes are required.

Vitamin D deficiency in the critically ill

“…Furthermore, accelerated bone loss has been shown in critically ill patients. This is presumably caused by systemic inflammation, generalized tissue catabolism and immobilization (28)(29)(30). Increased bone resorption is associated with increased mortality in the general population (31,32).…”

Evaluation of Bone Metabolism in Critically Ill Patients Using CTx and PINP

“…These factors, separately or in combination, may contribute to increased bone resorption and decreased bone formation [1]. This accelerated bone turnover may contribute to the burden of morbidity and mortality observed in survivors of intensive care [2, 3].…”

“…Although data are limited until now a positive association (moderate evidence) between critical illness requiring intensive care admission and increased bone turnover exists according to a recent systematic review [1]. However, the extent, risk factors, and the nature of the relationship between critical illness and bone turnover are not yet clearly understood [1].…”

“…However, the extent, risk factors, and the nature of the relationship between critical illness and bone turnover are not yet clearly understood [1]. …”

“…Also, studies have employed different methodologies and recruited heterogenous populations (differences in ages, gender, and population sizes) with varied duration of follow-up [1]. Most importantly they examined different serum or urinary markers of bone turnover which are not well documented and in variable timeframes.…”