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Lower vitamin D in elderly group with fractures – March 2013

Connection Between Bone Fractures, Vitamin D Level and Low-Energy Falls in Hospitalised Elderly Patients

Clinical pharmacy and clinical trials (including case series) CPC-036 
Eur J Hosp Pharm 2013;20:A178 doi:10.1136/ejhpharm-2013-000276.493
A Bor,
P Doró,
M Matuz,
Z Biczók,
R Viola,
G Soós
Univeristy of Szeged, Department of Clinical Pharmacy, Szeged, Hungary

Background The ageing of the population in developed countries is a growing problem today. Prevalence of chronic diseases, such as osteoporosis, increases with age. It is estimated that 900,000 people (9% of the population) above the age of fifty suffer from osteoporosis in Hungary. This condition greatly increases the risk of fractures of vertebra and the hip bone, which often lead to fatal consequences. Many studies have proven that a low vitamin D level increases the risk of bone fractures. Adequate vitamin D level is essential to prevent bone loss and structural damage of the bone matrix, which also prevents fractures.

Purpose To compare vitamin D levels of hospitalised hip fracture patients with hospitalised non-fractured patients, as well as to detect the prevalence of low-energy falls, and to analyse the differences between the groups.

Materials and Methods The fractured group was recruited from the Traumatology Department and the control group was recruited from the Internal Medicine Department. The control group was matched according to age and gender. Vitamin D levels were measured with an ELISA kit and were expressed in ng/ml. Subjects were asked about previous falls during a personal interview.

Results Twenty-two patients were in the fractured group (mean age 84.09 years, SD ± 6.78) and 33 patients were in the control group (mean age 80.52 years, SD ± 6.56).
The mean vitamin D level was

  • 33.13 ng/ml in the fractured group and
  • 39.7 ng/ml in the control group (P = 0.230).

However, the vitamin D level was under the normal range (30–60 ng/ml) in the majority of patients in both groups. Patients of the fractured group reported considerably more falls within one year than the control group.

Conclusions Since the difference in vitamin D levels was not significant between the investigated groups, other risk factors could be responsible for fractures besides the low vitamin D level. A noteworthy factor may be falls, because more than half of the fractured patients reported multiple falls in the previous year.

See also VitaminDWiki