Assessment of Vitamin D deficiency among older adult patients with an orthopaedic fracture and its association with increasing age (original) (raw)
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Correlation of serum vitamin D with hip fracturesin males more than 50 years of age
International Journal of Medical Research and Review, 2015
Introduction: Vitamin D is vital for bone health because it assists in the absorption and utilization of calcium. There are various studies in elderly females with hip fractures correlating the Vitamin D levels. But very few studies have evaluated the serum Vitamin D levels in males more than 50 years. Materials and Methods: Present study was conducted in the JIPMER Pondicherry between August 2012 and August 2013. A total of 41 male patients aged more than 50 years with fracture neck of femur and Intertrochanteric fracture were included. Blood samples were taken stored, processed and evaluated for vitamin D total (D2 and D3). The Values of Vitamin D obtained are shown into three groups as 0-20ng/ml-deficiency, 20-30ng/ml as insufficiency and>30ng/ml as normal Reference. Results: On analysis of Vitamin D we found that out of total 41 patients 9(22%) had vitamin D level <20ng /ml, 15(36%) had levels between 20ng-30ng/ml and 17 (41%) had >30ng/ml. Of the 21 patients with Neck of femur fractures Vitamin D<20ng/ml are 6(28.6%),20-30ng/ml are 9 (42.9) and >30ng/ml are 6(35.3).Vitamin D levels in 20 intertrochanteric fractures are<20ng/ml in 3(15%), 20-30ng/ml in 6(35%) and >30ng/ml in 11(55%). Conclusion: We found 24 patients (58%) have vitamin D level <30ng/ml, more in patients with neck femur fracture than intertrochanteric fractures. Present study found that there is no statistically significant correlation between the vitamin D level and proximal femoral fractures in elderly males (p=0.489).
International Journal of Research in Orthopaedics, 2018
Background: Proximal femoral fractures are very common in elderly patients. These fractures are thought to be associated with osteoporosis. Vitamin D is a possible risk factor for osteoporosis. So, this study was done to evaluate the association of serum vitamin D level with types of femoral fractures in elderly patients.Methods: The study was done between September 2013 to August 2016, 75 patients with age >60 years (male and female both) with proximal femoral fractures were studied. Serum 25-hydroxy vitamin D, calcium, phosphate, alkaline phosphatase levels, liver function test, renal function test, hemoglobin and complete blood counts of all the patients were assessed.Results: On assessment of serum vitamin D in proximal femoral fracture in elderly patients, it shows an increase incidence of proximal femoral fractures in patients with low serum vitamin D level. Fracture of neck of femur was most common among all. Type of fracture has no significant statistical relationship wit...
Journal of Orthopaedic Surgery
Background: Data of vitamin D sufficiency in Asian patients with osteoporotic fragility hip fractures are limited. This study aimed to obtain data from the Japanese population. Methods: Patients aged 60 years or older with hip fractures were prospectively enrolled. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured. Levels were compared between patients receiving and not receiving treatment for osteoporosis, those with and without previous contralateral hip fractures, and those with femoral neck versus trochanteric fractures. Sex-based differences were also assessed. The serum levels in patients younger than 60 years with extremity fractures were assessed, and differences between elderly and younger patients were evaluated. The individual correlation between 25(OH)D levels and the ultraviolet (UV) index and age was analyzed in elderly patients with hip fractures. Results: The data of 360 patients (aged 84.7 ± 8.2 years), comprising 80 men and 280 women, were analyzed. The mean...
Is Vitamin D deficiency an endangerment for Fracture?
Surgical Update: International Journal of Surgery and Orthopedics
Introduction: The incidence of fragility hip fracture is on a step increase. Vitamin D is essential for the growth and development of the bone. The decrease in the exposure to sun's radiation leads to this deficiency causing a global threat. There were many studies pointing towards Vitamin D deficiency as a risk factor for fracture. However, the relationship between serum Vitamin D and bone mineral density (BMD) in the senile osteoporotic fracture is still unclear. The aim of this study is to find out whether Vitamin D deficiency is a risk factor for fragility fracture. Method: It is a prospective study done at Sri Ramachandra Medical College Chennai and Velammal Medical college Madurai between Jan 2017 to Dec 2019. The inclusion criteria were male patients age more than seventy and female patients more than sixty presented with fragility hip fractures. The group I was the cases, patients with hip fractures. The group II was the age and gender-matched control. All the patients included in the study underwent both Vitamin D 25 OH and Dexa scan. The current study had 56 patients in group I as cases and 54 patients in group II as control. Results: The mean value of vitamin D 25OH in fracture patient group I was 19.85 and the age and gender-matched control group was 26.09. The current study had totally seventy-nine patients in the study who were either Vitamin D deficient or insufficient. The present study had 16 cases patient and 15 controls who were having sufficient level vitamin D. Conclusion: Vitamin D has no role in fracture prevention and certainly Vitamin D deficiency is not an endangerment for fractures.
Vitamin D deficiency as a risk factor for osteoporotic fractures
Bone, 2008
The evidence on the association between vitamin D deficiency and fracture incidence is contradictory. Therefore, the objective of this study was to examine whether low serum 25-hydroxyvitamin D (25(OH)D) levels are associated with osteoporotic fractures.
International Congress Series, 2007
Achievement of adequate vitamin D level is crucial for the treatment of hip fracture patients. A majority of elderly patients after hip fracture in Israel do not receive an appropriate and sufficient vitamin D and calcium supplementation in the community. The aim of this work was to assess the effect of 800 IU/day vitamin D 3 supplementation on vitamin D status and plasma PTH in elderly hip fracture patients. Patients and methods: 122 consecutive elderly patients after surgical hip fracture correction, aged 72.7 ± 9.46, were enrolled in the Post-Surgical Treatment Program (PSTP). Serum 25(OH)D 3 and plasma PTH levels were assessed during initial hospital stay and at consecutive quarterly follow-up visits. Results: At baseline 118 (97.5%) patients had 25(OH)D 3 serum level b 30 ng/mL. Forty (32.8%) patients were vitamin D deficient. After 3 months 29 (24%) patients were adherent to the supplement. The drop out rate at 1 year was 62%. The major reason for the discontinuation of participation was noncompliance. Thirty four adherent (27.8%) patients achieved 25(OH)D 3 concentration of 25 ng/mL at13.45 ± 4.9 months. Conclusions: Majority of elderly hip fracture patients had inadequate 25(OH)D 3 serum level and had not achieved an adequate vitamin D status with daily supplementation of 800 IU of vitamin D during 24 months follow up period. Supplementation strategies using periodic single high dose of vitamin D might be more appropriate and should be considered in these patients.
Osteoporosis and Sarcopenia, 2019
Objectives: To assess the vitamin D status in postmenopausal women with osteoporotic fractures, determine its concentration by fracture site at the clinical setting, and compare the proportion of vitamin D deficiency with that reported in literature. Methods: The prospective study included 317 postmenopausal women with osteoporotic fractures who were treated consecutively from 2016 to 2018. After obtaining informed consent for participation in the seamless treatment of osteoporosis against fractures study, which is our initiative to prevent secondary osteoporotic fractures, we registered the patients, examined bone mineral density (BMD) at the unfractured femoral neck and lumbar spine, serum 25-hydroxyvitamin D (25(OH)D) concentration, blood chemistry, and bone turnover markers. Results: The mean age of the patients was 80.7 years. Moreover, 78% of patients of all fractures had 25(OH)D concentration < 20 ng/mL, whereas 12% of patients had 25(OH)D concentration ! 30 ng/mL 25(OH)D concentration in hip fractures was significantly lower than that in vertebral or distal radius fractures (P < 0.05). Multiple regression analysis revealed that 25(OH)D concentration is significantly associated with femoral neck BMD (b ¼ 0.16; 95% confidence interval [CI], 0.78e12.17, P ¼ 0.03) and serum albumin concentration (b ¼ 0.21; 95% CI, 0.62e2.96, P < 0.001) in patients with 25(OH)D concentration < 30 ng/mL. Conclusions: The results of this study show that the proportion of postmenopausal women with osteoporotic fractures who had vitamin D deficiency was higher than the proportion in previous reports that examined general postmenopausal women (35.2%e52.0%).
The Journal of the Association of Physicians of India, 2010
To assess vitamin D nutrition status in Asian-Indian patients with fragility hip fracture. The study subjects included patients with non-traumatic hip fracture with age more than 50 years. Any patient who sustained fracture after road side accident of any severity was excluded. The other exclusion criteria were history of previous non-traumatic fracture or history of intake of systemic steroids, anti-osteoporotic medication, anti-tubercular or antiepileptic drugs. Routine biochemistry, serum 25-hydroxy vitamin D [25(OH)D] and BMD (DXA) were measured in all patients. Diagnosis of vitamin D deficiency (VDD) was considered when serum 25(OH)D levels were < 20 ng/ml. Age and sex matched apparently healthy subjects (without history of fracture at any site) were selected from general population. All controls under went BMD measurement at spine. Final analysis included 43 patients, 9 men (20.9%) and 34 women (79.0%, all postmenopausal). The mean age of patients was 62.2 +/- 12.3 years (r...
2021
Vitamin D is associated to bone health and reduction in the incidence of fractures. However, this condition remains increasing specially during elderly, predisposing to frailty and increasing hospital stay days. The reduction in vitamin D levels could explain the high incidence of fractures as well as mortality. This is an observational transversal retrospective study. This study aimed to determine the relation between frailty and fractures in patients with low vitamin D levels. We found 914 patients with vitamin D levels; however, we included just 319 patients who had previous imaging study, vitamin D determination, and confirmed diagnosis of frailty. Patients with surgical fractures, chronic kidney disease or vitamin D supplementation were excluded from this study. The main fractures related to long hospital stay (> 5 days), frailty, and low vitamin D levels were clavicle fracture; however, scaphoids fracture was related to shorter hospital stay and higher vitamin D levels. Most of fractures happened over 60 years old in women and under 60 years old in men. Vitamin D deficiency was related to long hospital stay in all fractures, despite the deficiency, vitamin D levels over 12 ng/mL were related to better outcomes in all patients; however, serum vitamin D levels related to the incidence of fracture were lower than reported in literature.
Vitamin D deficiency is associated with cortical bone loss and fractures in the elderly
European Journal of Endocrinology, 2019
Introduction The role of vitamin D on bone microarchitecture and fragility is not clear. Objective To investigate whether vitamin D deficiency (25(OH)D <20 ng/mL) increases cortical bone loss and the severity of fractures. Design Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture. Methods Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high-resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure. Results Serum 25(OH)D levels were associated with body mass index (BMI: r = −0.161, P = 0.006), PTH (r = −0.165; P = 0.005), CTX (r = −0.119; P = 0.043) and vBMD at cortical bone (Dcomp: r = 0.132; P = 0.033) and entire bone (D100: r = 0.162 P = 0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI: 0.11–4.16; P < 0.01), 25(OH)D (95% ...