Patients presenting with fractures are likely to be vitamin D deficient: are we getting enough sun?

Abstract

BACKGROUND:

25-Hydroxyvitamin D serves a crucial role in bone metabolism through its role on osteoclast and osteoblastic function. To assess the implication of vitamin D and its relationship to bone fracture and fracture force, we have examined vitamin D levels in patients requiring inpatient fracture management.

METHODS:

We performed serological testing of vitamin D levels, calcium, parathyroid hormone and liver function tests on patients admitted to our rural institution in southeastern Australia for inpatient fracture management. All participants completed a questionnaire designed to screen for potential contributing factors to bony fragility. Demographic data were also obtained including age, gender and body mass index. Fracture location and the type of inpatient management as well as the force of injury were included in our analysis.

RESULTS:

We recruited 100 patients to the study, with a median age of 72 (range 22-98) of whom 66 were women. Most had low-energy fractures (79%), treated by internal fixation (73%) or arthroplasty (9%) with 18 treated non-operatively. The majority of the patients were at best vitamin D insufficient, <75 nmol/L (77%), and 38% were vitamin D deficient (<50 nmol/L). Only 14 patients had a formal diagnosis of osteoporosis at presentation, with 63 patients claiming daily sun exposure in line with recommendations for vitamin D sufficiency.

CONCLUSIONS:

Our data suggest that the prevalence of vitamin D insufficiency and deficiency is common in patients presenting with fractures in southeastern Australia and is not confined to elderly patients. All patients with fractures should be assessed for vitamin D levels and treated in accordance with vitamin D deficiency guidelines.

• Authors: Tyler C Mow, Christopher M Stokes, Alasdair G Sutherland
• Journal: ANZ journal of surgery (ANZ J Surg) Vol. 85 Issue 10 Pg. 766-9 (Oct 2015) ISSN: 1445-2197 [Electronic] Australia
• PMID: 26011539 (Publication Type: Journal Article)
• Copyright: © 2015 Royal Australasian College of Surgeons.

Chemical References

• Parathyroid Hormone
• Vitamin D
• 25-hydroxyvitamin D
• Calcium

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthroplasty (methods, statistics & numerical data)
• Australia (epidemiology)
• Body Mass Index
• Calcium (blood)
• Cohort Studies
• Female
• Fracture Fixation, Internal (methods, statistics & numerical data)
• Fractures, Bone (blood, epidemiology, surgery)
• Humans
• Male
• Middle Aged
• Osteoclasts (metabolism)
• Parathyroid Hormone (blood)
• Prevalence
• Sunlight
• Surveys and Questionnaires
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, epidemiology)
• Young Adult