Low 25(OH) D serum levels are related with hip fracture in postmenopausal women: a matched case–control study
Journal of Translational Medicine 2015, 13:388 doi:10.1186/s12967-015-0756-x
Xing-Mao Fu*†, Shao-Guang Fan†, Shu-Liang Li, Yi-Sheng Chen, Hai Wu and Yan-Long Guo
* Corresponding author: Xing-Mao Fu fxm70xe at 126.com; † Equal contributors
Institute of Traumatic Orthopedics, The 89th Hospital of People’s Liberation Army, No. 256 Beigongxi Str, Weifang 261021, Shandong Province, People’s Republic of China
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Hip fracture 50 percent more likely if low in both vitamin D and vitamin K1 – Dec 2015
- Hip fractures reduced 2X to 6X with just 10 minutes of sunlight daily – RCT 2003-2010
- Hip Fracture 2.5 times more likely if poor Vitamin D Binding Protein gene - Aug 2015
- Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013
- Hip fracture outcome 5X more likely to be poor if low vitamin D – Jan 2015
- Hip fracture risk increased 2.5X if problem with Vitamin D Receptor gene (GC) – March 2014
Purpose: There is limited information on the prevalence of vitamin D deficiency among patients diagnosed with hip fracture in the Chinese Han population. Therefore, the aim of this study was to assess the effects of change in the serum levels of 25-hydroxyvitamin D [25(OH) D] and intact parathyroid hormone (iPTH) among postmenopausal women in North China with confirmed hip fracture.
Methods: This study was done from May 1, 2012 to April 30, 2014. Three hundred and forty-nine postmenopausal women who were diagnosed with first-ever hip fracture and 349 matched controls without fracture were used for this study. The 25(OH) D, iPTH, alkaline phosphatase, calcium, and phosphorus levels were measured in fasting venous blood samples collected from the subjects. A predesigned questionnaire was used to collect information on covariates for multivariate analyses to evaluate the hypothesized relationship between vitamin D deficiency and fracture risk.
Results: The serum 25(OH) D levels were found to be significantly (P < 0.0001) lower in hip fracture patients than in the controls [37.0 (interquartile range [[IQR] 28.0–48.0) nmol/L vs. 41.3 (IQR 32.0–54.5) nmol/L; P < 0.0001], and the iPTH levels were significantly higher in the former group [10.2 (IQR 6.3–14.9) pmol/L vs. 5.8 (IQR 4.1–6.6) pmol/L; P < 0.0001].
Further, a 25(OH) D level ≤50 nmol/L was found to independently indicate the occurrence of hip fracture [odds ratio (OR), 3.023; 95 % confidence interval (CI) 2.154–4.298], as well as hip fracture with concomitant upper limb fracture (OR 4.473; 95 % CI 2.984–10.532). Similarly, a serum iPTH level ≥6.8 pmol/L independently indicated the development of hip fracture (OR 2.498; 95 % CI 1.764–3.942), as well as hip fracture with concomitant upper limb fracture (OR 3.254; 95 % CI 1.998–7.984).
Conclusions: Vitamin D insufficiency and secondary hyperparathyroidism were found to be common problems in the sample of postmenopausal women who had experienced hip fracture. Monitoring the alterations in the serum levels of 25(OH) D and iPTH could be applied clinically as independent risk factors for hip fracture.