Hypovitaminosis D as a risk factor of hip fracture severity

Osteoporos Int. 2012 Feb;23(2):607-14. doi: 10.1007/s00198-011-1588-z. Epub 2011 Mar 11.

Abstract

Summary: In a cross-sectional study including 324 patients older than 65 years admitted to our hospital for osteoporotic hip fracture, we found that those patients with a more severe vitamin D deficiency had more severe osteoporotic hip fractures (Garden grades III-IV and Kyle III-IV).

Introduction: To identify possible differences in baseline characteristics of patients with different types of osteoporotic hip fracture.

Methods: Cross-sectional study including consecutive individuals over 65 admitted to our hospital for osteoporotic hip fracture over a year. Demographic data, fracture type, comorbidities, history of osteoporosis, functional capacity, nutritional status and vitamin D storage were evaluated.

Results: We included 324 patients (83 ± 7 years, 80% women). Two hundred sixteen patients (67%) had vitamin D deficiency (25OHD3 <25 ng/ml). In patients with severe femoral neck or intertrochanteric fractures (Garden III-IV and Kyle III-IV), vitamin D deficiency was more frequent (74%) and severe (25OHD3 20 ± 15 ng/ml) than in patients with less severe fractures (57%, 25OHD3 26 ± 21 ng/ml). Forty-three percent of patients had previous fractures. Only 15% of patients had been previously diagnosed with osteoporosis and 10% were receiving treatment. Patients receiving vitamin D supplements have higher 20OHD3 levels and less severe fractures.

Conclusions: Although vitamin D levels are not different between patients with intracapsular or extracapsular hip fractures, a more severe vitamin D deficiency seems to be associated to more severe osteoporotic hip fractures. A prior vitamin D supplementation could avoid a higher severity of these fractures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Calcifediol / blood
  • Cross-Sectional Studies
  • Dietary Supplements
  • Female
  • Femoral Neck Fractures / blood
  • Femoral Neck Fractures / etiology
  • Femoral Neck Fractures / prevention & control
  • Hip Fractures / blood
  • Hip Fractures / etiology*
  • Hip Fractures / prevention & control
  • Humans
  • Male
  • Nutritional Status
  • Osteoporotic Fractures / blood
  • Osteoporotic Fractures / etiology*
  • Osteoporotic Fractures / prevention & control
  • Risk Factors
  • Trauma Severity Indices
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / drug therapy

Substances

  • Vitamin D
  • Calcifediol