Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D

Guerra, Marcelo Teodoro Ezequiel; Feron, Eduardo Terra; Viana, Roberto Deves; Maboni, Jonathan; Pastore, Stéfany Ignêz; Castro, Cyntia Cordeiro de

doi:10.1016/j.rboe.2016.08.013

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ORIGINAL ARTICLES • Rev. bras. ortop. 51 (05) • Sep-Oct 2016 • https://doi.org/10.1016/j.rboe.2016.08.013 copy

Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D^☆ ☆ Study conducted at the Universidade Luterana do Brasil (Ulbra), Hospital Universitário, Departamento de Ortopedia e Traumatologia, Canoas, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To compare serum 25-hydroxyvitamin D (25[OH]D) levels, a serum marker of vitamin D3, between patients with and without proximal hip fracture.

METHODS:

This was a case-control study in which serum samples of 25(OH)D were obtained from 110 proximal hip fracture inpatients and 231 control patients without fractures, all over 60 years of age. Levels of 25(OH)D lower than or equal to 20 ng/mL were considered deficient; from 21 ng/mL to 29 ng/mL, insufficient; and above 30 ng/mL, sufficient. Sex, age, and ethnicity were considered for association with the study groups and 25(OH)D levels.

RESULTS:

Patients with proximal hip fracture had significantly lower serum 25(OH)D levels (21.07 ng/mL) than controls (28.59 ng/mL; p = 0.000). Among patients with proximal hip fracture, 54.5% had deficient 25(OH)D levels, 27.2% had insufficient levels, and only 18.2% had sufficient levels. In the control group, 30.3% of patients had deficient 25(OH)D levels, 30.7% had insufficient levels, and 38.9% had sufficient levels. Female patients had decreased serum 25(OH)D levels both in the fracture group and in the control group (19.50 ng/mL vs. 26.94 ng/mL; p = 0.000) when compared with male patients with and without fracture (25.67 ng/mL vs. 33.74 ng/mL; p = 0.017). Regarding age, there was a significant association between 25(OH)D levels and risk of fracture only for the age groups 71-75 years and above 80 years.

CONCLUSION:

Patients with proximal hip fracture had significantly decreased serum 25(OH)D levels when compared with the control group. Female patients had significantly lower serum 25(OH)D levels in both groups.

Keywords:
Vitamin D deficiency; Hip fractures; Osteoporotic fractures

Variable	Group						p
	Control (n = 231)		Fracture (n = 110)		Total (n = 341)
	n	%	n	%	n	%
Ethnicity
White	218	94.4	106	96.4	324	95.0	0.839^a
Black	9	3.9	3	2.7	12	3.5
Mixed	4	1.7	1	0.9	5	1.5

Sex
Female	175	75.8	82	74.5	257	75.4	0.808^b
Male	56	24.2	28	25.5	84	24.6	0.808^b

Age (years)
60–65	24	10.4	12	10.9	36	10.6	0.850^b
66–70	16	6.9	8	7.3	24	7.0
71–75	50	21.6	21	19.1	71	20.8
76–80	51	22.1	20	18.2	71	20.8
>80	90	39.0	49	44.5	139	40.8

class

Age	Group	n	Mean	SD	p^a
60–65 years	Control	24	31.5	11.52	0.327
60–65 years	Fracture	12	24.1	14.38	0.327
66–70 years	Control	16	32.22	10.58	0.417
66–70 years	Fracture	8	29.19	11.79	0.417
71–75 years	Control	50	28.43	11.37	0.3
71–75 years	Fracture	21	20.50	8.33	0.3
76–80 years	Control	51	30.82	9.96	0.95
76–80 years	Fracture	20	25.83	9.61	0.95
>80 years	Control	90	26.11	14.8	0.3
>80 years	Fracture	49	17.34	8.37	0.3

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: mguerraz@hotmail.com(M.T. Guerra).

25(OH)D	Control		Fracture		Total
	n	%	n	%	n	%
Deficient	70	30.3	60	54.5	130	38.1
Insufficient	71	30.7	30	27.2	101	29.6
Sufficient	90	38.9	20	18.2	110	32.2
Total	231	100.0	110	100.0	341	100.0

Ethnicity	Control			Fracture
	n	Mean	SD	n	Mean	SD
White	218	28.73	12.30	106	20.76	10.10
Mixed	9	23.38	10.77	3	29.59	16.32
Black	4	32.83	16.24	1	28.50	0.0

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Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D☆ ☆ Study conducted at the Universidade Luterana do Brasil (Ulbra), Hospital Universitário, Departamento de Ortopedia e Traumatologia, Canoas, RS, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D^☆ ☆ Study conducted at the Universidade Luterana do Brasil (Ulbra), Hospital Universitário, Departamento de Ortopedia e Traumatologia, Canoas, RS, Brazil.