[Should the vitamin D level be determined for all fracture patients?]

Ned Tijdschr Geneeskd. 2010:154:A1758.
[Article in Dutch]

Abstract

Vitamin D deficiency is endemic worldwide. The Health Council of the Netherlands advises a colecalciferol intake of 800 IU/day and an intended serum level of calcidiol of at least 50 nmol/l for people aged 50 years and older and for osteoporosis patients. In 64% of 626 fracture patients, we found a reduced serum calcidiol level according to this definition. According to calculations based on meta-analyses, a substantial proportion of fracture patients would not achieve the target calcidiol level of 50 nmol/l with a vitamin D supplement of 800 IU/day. For example, this would be the case in 37% of elderly patients with osteoporosis. Until the results of a prospective study on this are published, we propose that fracture patients are either systematically given doses of vitamin D supplements higher than 800 IU/day, or that their serum calcidiol is measured and the dose of vitamin D supplements is adjusted according to this initial value and the desired serum concentrations, and that the measurement is repeated after 3 months so that the dosage can be adjusted if necessary.

Publication types

  • English Abstract

MeSH terms

  • Aged
  • Aging
  • Bone Density Conservation Agents / blood
  • Bone Density Conservation Agents / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Fractures, Bone / blood
  • Fractures, Bone / etiology*
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Osteoporosis / complications*
  • Osteoporosis / drug therapy
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood*
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / drug therapy

Substances

  • Bone Density Conservation Agents
  • Vitamin D