Distribution and Correlates of Serum 25-Hydroxyvitamin D Levels in a Sample of Patients with Hip Fracture

Pieper, Carl F.; Colón‐Emeric, Cathleen; Caminis, John; Betchyk, Kathleen; Zhang, Jie; Janning, Cheri; Shostak, John; LeBoff, Meryl S.; Heaney, Robert R; Lyles, Kenneth W.

doi:10.1016/j.amjopharm.2007.12.004

Cited by 38 publications

(24 citation statements)

References 23 publications

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“…17,18 Inadequate vitamin D levels have been demonstrated in patients with osteoporosis, 19 including in hip fracture patients in many countries, although low levels may be influenced by the fracture itself. [20][21][22] It is also important to note that vitamin D deficiency increases with ageing and that this contributes independently to secondary hyperparathyroidism. 23 In addition, serum androgen levels in men are associated with serum 25(OH)D levels and both hormones have a concordant annual periodicity being lowest in late winter, 24 suggesting important, and as yet unidentified, links between the vitamin D and sex-steroid axes.…”

Section: Effects Of Season On Bone Healthmentioning

confidence: 99%

Vitamin D and bone health: Epidemiologic studies

Ebeling¹

2014

BoneKEy Reports

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Allelic variation in the vitamin D receptor was the first non-structural gene to be associated with osteoporosis, and together with the effects of the vitamin D system on bone homeostasis, suggested that this vitamin might have a strong role in bone health. However, controversy exists regarding what level of serum 25-hydroxyvitamin D (25(OH)D) is optimal. Current data from biochemical, observational and randomized controlled trials (RCTs), indicate serum 25(OH)D levels of at least 50 nmol l À 1 are required for normalization of parathyroid hormone (PTH) levels, to minimize the risk of osteomalacia and for optimal bone cell function. The skeletal consequences of 25(OH)D insufficiency include secondary hyperparathyroidism, increased bone turnover and bone loss and an increased risk of minimal trauma fractures. In large scale epidemiological studies, serum 25(OH)D levels are associated with bone mineral density in both men and women. However, there is mixed evidence on the effectiveness of optimizing serum 25(OH)D levels for the prevention of bone loss and minimal trauma fractures in postmenopausal women and older men. There may be some benefit on primary fracture prevention for those who have inadequate serum levels of 25(OH)D, particularly in institutionalised elderly patients, but only when combined with calcium supplements. For optimal bone health, evidence from RCTs suggests vitamin D may be considered a threshold nutrient with few further bone benefits observed at levels of 25(OH)D above which PTH is normalized. An adequate calcium intake is also imperative to gain optimum benefit from an improved vitamin D status in those with insufficient 25(OH)D levels, with an increased calcium intake being associated with suppression of PTH levels. A large, multicentre, genome-wide association study of 15 cohorts, comprising about 30 000 white people from European descent, found that polymorphisms at three different loci involved in vitamin D metabolism affect serum 25(OH)D levels and the risk of vitamin D deficiency. 4 After accounting for age, sex, body mass index and season, polymorphisms in at least three, and perhaps four loci, influenced serum 25(OH)D levels: (1) 4p12 polymorphisms near or within the GC gene, which encodes vitamin D binding protein, the main transporter of vitamin D metabolites in the blood; (2) 11q12 polymorphisms near DHCR7/NADSYN1, encoding the enzyme 7-dehydrocholesterol reductase, which converts 7-dehydrocholesterol into cholesterol in the skin thereby removing the substrate for production of vitamin D 3 ; (3) 11p15 polymorphisms near CYP2R1, which encodes an enzyme responsible for 25-hydroxylation of vitamin D in the liver; (4) CYP24A1 encoding 24-hydroxylase, which initiates degradation of 25(OH)D and 1,25(OH) 2 D. Participants with a genotype score (combining the three main variants) in the top quartile had twice the risk of having vitamin D insufficiency (o50 or 75 nmol l À 1 ) than those in the lowest quartile. It was also associated with a 1.5-fold risk of severe vitamin D deficiency (o2...

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Section: Effects Of Season On Bone Healthmentioning

confidence: 99%

Vitamin D and bone health: Epidemiologic studies

Ebeling¹

2014

BoneKEy Reports

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“…[8][9][10][11][12][13][14] There is conflicting evidence with regard to the association of vitamin D deficiency with the occurrence of osteoporotic fractures. [15][16][17][18][19][20] A study from Hong Kong showed that hypovitaminosis D was common among elderly patients with femoral neck fractures. 21 A similar study on Japanese postmenopausal women living in Hawaii did not find any significant association between 25(OH)D and either vertebral or nonvertebral fractures.…”

Section: Figure 1 Scatter Plot Of Ipth Versus 25(oh)d Among All Patimentioning

confidence: 99%

Vitamin D Levels, Physical and Biochemical Characteristicsof South East Asian Patients with Osteoporotic Hip Fractures

Chandran

Howe

Goh

et al. 2012

JAFES

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Objective. Limited information exists on the physical characteristics, bone mineral density (BMD), 25-hydroxyvitamin D [25(OH)D] levels and other biochemical parameters in patients with hip fractures in Asia. We aimed to explore whether these parameters differ between trochanteric and femoral neck (cervical) hip fractures in Singaporean patients.Methodology. 275 patients with osteoporotic hip fractures were evaluated. Multivariate regression models were used to investigate the relationship between physical characteristics, biochemical parameters, renal function, BMD and type of hip fracture.Results. The mean 25(OH)D level noted was 20.4 (8.1) ng/mL. Fifty percent of patients had levels less than 20 ng/mL. Patients with trochanteric fractures were heavier than those with cervical fractures (p=0.021). Logistic regression analysis showed that males were more likely to have trochanteric fractures (OR=1.79, 95% CI 1.03-3.11), and females with trochanteric fractures were older than those with cervical fractures (OR=0.97, 95% CI 0.94-1.00).Conclusion. Vitamin D deficiency was prevalent in half of our population of hip fracture patients. Trochanteric fractures were more common than cervical fractures in men and in older women. In contrast to findings noted in Caucasian populations, neither BMD nor other bone metabolic parameters examined were associated with the preferential occurrence of one type of osteoporotic hip fracture over the other.

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“…Randomized placebo-controlled trials have demonstrated that vitamin D supplementation prevents falls (1) and fractures (2, 3), at least in the 35%-60% of the population with insufficient serum 25-hydroxyvitamin D [25(OH)D] levels (4,5). In addition, epidemiologic evidence links low vitamin D levels with a variety of illnesses, including diabetes, cardiovascular disease, COPD, respiratory infections, autoimmune diseases, and cancers (6), although it remains to be proven that supplements prevent adverse outcomes in these diseases.…”

Section: Current Therapymentioning

confidence: 99%