Hypovitaminosis D as a risk factor of hip fracture severity

Larrosa, M.; Gómez, Antonio; Casado, Enrique; Moreno, Mireia; Vázquez, Ivonne; Orellana, C.; Berlanga, Eugenio; Ramon, Jordi; Gratacós, Jordi

doi:10.1007/s00198-011-1588-z

Cited by 47 publications

(35 citation statements)

References 27 publications

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“…Other studies have demonstrated that a low vitamin D level or vitamin D deficiency is associated with increased risks for respiratory diseases such as respiratory tract infections [38,39], chronic bronchitis [40], and chronic obstructive pulmonary disease [41,42], and associated with increased mortality in patients with influenza infection [43] and pneumonia [44]. In addition, vitamin D deficiency is associated with low bone density resulting in increased risks of osteoporotic fractures and physical disabilities [45][46][47]. Taken together, these findings may provide insights into potential mechanisms for the survival benefits from higher levels of vitamin D at baseline.…”

Section: Discussionmentioning

confidence: 98%

Serum 25-hydroxyvitamin D levels and all-cause and cardiovascular disease mortality among US adults with hypertension

Zhao

Ford

et al. 2012

Journal of Hypertension

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Section: Discussionmentioning

confidence: 98%

Serum 25-hydroxyvitamin D levels and all-cause and cardiovascular disease mortality among US adults with hypertension

Zhao

Ford

et al. 2012

Journal of Hypertension

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“…These limits vary from 20 ng/mL (50 nmol/L) [28] to 36 ng/mL (90 nmol/L) [27], depending on the target population and the geographical region where BMD was measured. Similarly, a decrease was observed in the incidence of fractures in individuals with 25(OH)D 3 serum levels greater than 12 ng/mL (30 nmol/L) [30] and the average mean 25(OH)D 3 levels were higher in subjects with less severe fractures compared to those with severe fractures [31]. It is noteworthy that these reference values seem to be the same at which PTH level stabilization occurs [32], i.e ., 25(OH)D 3 levels sufficient to establish the best relationship with BMD and with fracture risks are also responsible for the lower levels of PTH, suggesting an important role of PTH in the process.…”

Section: Vitamin D and Osteoporosismentioning

confidence: 99%

Vitamin D: Link between Osteoporosis, Obesity, and Diabetes?

Cândido

Bressan

2014

IJMS

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Vitamin D (1,25(OH)2D3) is a steroid hormone that has a range of physiological functions in skeletal and nonskeletal tissues, and can contribute to prevent and/or treat osteoporosis, obesity, and Type 2 diabetes mellitus (T2DM). In bone metabolism, vitamin D increases the plasma levels of calcium and phosphorus, regulates osteoblast and osteoclast the activity, and combats PTH hypersecretion, promoting bone formation and preventing/treating osteoporosis. This evidence is supported by most clinical studies, especially those that have included calcium and assessed the effects of vitamin D doses (≥800 IU/day) on bone mineral density. However, annual megadoses should be avoided as they impair bone health. Recent findings suggest that low serum vitamin D is the consequence (not the cause) of obesity and the results from randomized double-blind clinical trials are still scarce and inconclusive to establish the relationship between vitamin D, obesity, and T2DM. Nevertheless, there is evidence that vitamin D inhibits fat accumulation, increases insulin synthesis and preserves pancreatic islet cells, decreases insulin resistance and reduces hunger, favoring obesity and T2DM control. To date, there is not enough scientific evidence to support the use of vitamin D as a pathway to prevent and/or treat obesity and T2DM.

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“…At 12 months mortality rates were 14.5% and 13.4%, respectively [27] . However, stratifying treatment to severity of hip fractures may be associated with considerable bias, since a higher degree of fracture displacement is significantly associated with hypovitaminosis D [28] which in turn may affect morbidity and mortality in these patients [7] . Only one retrospective study found a higher cumulative mortality after internal fixation compared to HA [29] .…”

Section: Discussionmentioning

confidence: 99%

“…Strikingly, recruitment of most patients in recent studies comparing IF with arthroplasty in hip fracture patients date back a decade or even longer [8][9][10][11]17,18,27,[21][22][23][24][25][26][27][28][29][30][31][32][33][34] . In this regard, improved anaesthesia and modern cementing techniques might explain the difference of our results compared to earlier studies.…”

Section: Discussionmentioning

confidence: 99%

Influence of Internal Fixation and Cemented Hemiarthroplasty on 1-Year Mortality in Geriatric Hip Fracture Patients

Fakler

Gräfe

Dercks

et al. 2017

International Journal of Orthopaedics

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AIM:Results after cemented Hemiarthoplasty (HA) in elderly patients with a femoral neck fracture improved over the last 20 years. We conducted this study in order to evaluate the influence of modern cemented HA compared to IF with a sliding hip screw (SHS) with regard to one year mortality. PATIENTS AND METHODS: 183 patients with a low-energy medial femoral neck fracture (AO/OTA 31-B) either treated with a SHS (n = 67) or cemented HA (n = 116) were included. Follow-up was performed at 6 and 12 months. A multivariate Cox regression analysis including nine confounding variables (age, ASA score, body mass index (BMI), cognitive function, time from admission to surgery, creatinine, c-reactive protein (CRP), 25-hydroxyvitamin D (25(OH)D) was performed. RESULTS: Patients in the HA group were significantly older (p < 0.001) and had more severe comorbidities according to the ASAScore (p = 0.017). The time interval from admission to surgery (skin incision) was beyond 48h in 6.0% of SHS patients and 17.2% in HA patients (p < 0.001). Despite of detrimental prerequisites for cemented HA, mortality rates at 1 year for HA (23.3%) showed no significant difference (p = 0.58) to IF (19.4%). After correcting for confounding variables mortality risk at one year was significantly higher in patients treated with a SHS (HR = 2.5, 95%CI 1.1-5.7; p = 0.027). CONCLUSION: We conclude that elderly patients with a femoral neck fracture might benefit from cemented HA compared to IF with a SHS in terms of 1-year mortality. New randomised controlled trials considering modern cementing techniques are needed to validate these results.

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Hypovitaminosis D as a risk factor of hip fracture severity

Cited by 47 publications

References 27 publications

Serum 25-hydroxyvitamin D levels and all-cause and cardiovascular disease mortality among US adults with hypertension

Serum 25-hydroxyvitamin D levels and all-cause and cardiovascular disease mortality among US adults with hypertension

Vitamin D: Link between Osteoporosis, Obesity, and Diabetes?

Influence of Internal Fixation and Cemented Hemiarthroplasty on 1-Year Mortality in Geriatric Hip Fracture Patients

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