Decrease in serum calcitriol (but not free 25-hydroxyvitamin D) concentration in hip fracture healing

Abstract

Objective To assess the decrease in serum calcitriol concentrations after hip fracture. Methods Serum concentrations of calcitriol, 25(OH)D, parathyroid hormone (PTH), directly measured free 25(OH)D, and indices of bone formation were measured in elderly patients with hip fracture (HF) and patients with elective hip replacement (EHR) at admission and after 7 weeks. Results A total of 45 patients with HF and 17 patients with EHR completed this prospective study. Baseline serum calcitriol levels were ≤ 60 pmol/l in 26% of the HF patients. After 7 weeks, they significantly decreased (p < 0.001). In patients with EHR, serum calcitriol was within the reference range in all but one patient and did not change during the 7-week recovery phase. Seven weeks after HF, a significant positive relationship was observed between the change in calcitriol and serum 25(OH)D concentration (r = 0.385, p = 0.009) and free 25(OH)D (r = 0.296, p = 0.048), and a decrease in calcitriol during recovery was associated with a decrease in serum PTH (p = 0.038). Seven weeks after HF, changes in both serum PTH and serum 25(OH)D concentrations contributed to the prediction of changes in serum calcitriol (R 2 = 0.190, p = 0.012). Conclusions Unlike patients with EHR, subjects with HF had low serum 25(OH)D and low free 25(OH)D concentrations at admission, while their serum 1,25D levels were relatively elevated. Decreases in circulating calcitriol levels in the 7 weeks following hip surgery were associated with a resolution of secondary hyperparathyroidism and low availability of free 25(OH)D.

Older adults and vitamin D hip fracture connections-what is the 2022 research base indicating?

“…Vaculik et al, 23 have shown that baseline serum levels of vitamin D or calcitriol levels tended to be lower than those of total hip arthroplasty cases undergoing similar surgeries. Moreover, after seven weeks, these levels decreased significantly in those with hip fractures.…”

Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment

“…Other additional TBI injuries such as bone fractures also have a major impact on endocrine mechanisms. Following bone fracture and heterotopic ossification, alterations have been observed for OCN, insulin, [ 168 ], calcitriol (1-,25-Vit-D3) and calcidiol (25-VitD3) [ 180 , 181 ]. Consequent haemorrhage and anaemia can trigger elevated systemic erythropoietin (EPO) levels [ 182 , 183 ].…”