Serum Levels of 25-Hydroxyvitamin D and Functional Outcome among Postmenopausal Women with Hip Fracture

Abstract

ObjectiveThe main objective of the current study was to assess the distribution and its prognostic value of serum 25-hydroxyvitamin D (25[OH] D) levels assessed at admission in Chinese postmenopausal women with hip fracture.MethodsFrom January 1, 2012 to December 31, 2013, all postmenopausal women with first-ever hip fracture were recruited to participate in the study. Serum 25[OH] D levels were measured at admission. The functional evaluation at the time of discharge was performed by the Barthel Index (BI). The prognostic value of 25[OH] D to predict the functional outcome within discharge was analyzed by logistic regression analysis, after adjusting for the possible confounders.ResultsIn our study, 261 patients were included and assessed. In the 76 patients with an unfavorable functional outcome, serum 25(OH) D levels were lower compared with those in patients with a favorable outcome [11.8(IQR, 9.9–16.1)ng/ml; 16.8(IQR, 13.6–21.4)ng/ml, respectively; P<0.0001]. In multivariate analysis, there was an increased risk of unfavorable outcome associated with serum 25(OH) D levels ≤ 20ng/ml (OR 5.24, 95%CI: 3.11–8.15; P<0.0001) after adjusting for possible confounders.ConclusionsOur data support an association between serum 25[OH] D levels and prognosis in Chinese postmenopausal women with hip fracture.

Prognostic Relevance of Circulating 25OHD Fractions for Early Recovery and Survival in Patients with Hip Fracture

“…Many authors reported on the connection between fracture risk and VD deficiency [ 1 , 3 , 6 , 26 ]. Nevertheless, there is few data on the relation between VD status, postoperative healing [ 9 , 14 , 15 , 16 , 17 ] and survival [ 2 , 4 , 7 , 8 ]. All these studies focused on the t-25OHD levels without binding proteins and the outcome after surgery without considering lifestyle and MCD.…”

“…Wang et al [ 17 ] reported similar results, but their threshold limit was higher (29.5 nmol/L) than ours (22.6 nmol/L). According to Liu et al [ 14 ], 76 patients with an unfavorable functional outcome had lower serum t-25OHD levels, compared to those with better functional performance.…”

“…Sufficient VD status plays important roles in both fracture prevention and post-surgical recovery, because it improves muscle strength and improves quality of life during healing, while also reducing the risks for chronic diseases such as diabetes, cancer, osteoporosis and cardiovascular events [ 10 , 11 , 12 , 13 ]. Nevertheless, the relation between VD status and healing after hip fractures had not been sufficiently addressed [ 14 , 15 , 16 , 17 ].…”

Low 25(OH) D serum levels are related with hip fracture in postmenopausal women: a matched case–control study

“…Van et al [ 28 ] reported that a serum level of 25(OH) D <30 nmol/L was associated with an increased risk of fractures in the youngest, but not in the oldest, age group after adjustment for confounders. Interestingly, Liu et al [ 29 ] found that there was an association between serum 25(OH) D levels and prognosis in Chinese postmenopausal women with hip fracture. Differences in the assay and sample test methods, subject populations, and analytic platforms used may explain the inconsistencies among studies.…”

“…In our study, 72.3 % of subjects with hip fracture had vitamin D levels less than 50 nmol/L, and 63.6 % had hyperparathyroidism. Similarly, in another Chinese sample, almost four-fifths of the hip fracture patients (78.9 %) had vitamin D deficiency [ 29 ].…”