Secondary Hyperparathyroidism in Patients from Western Australia with Hip Fracture: Relationship to Type of Hip Fracture, Renal Function, and Vitamin D Deficiency

Bruce, David; John, Andrew St; Nicklason, F.; Goldswain, Peter

doi:10.1111/j.1532-5415.1999.tb03001.x

Cited by 61 publications

(22 citation statements)

References 30 publications

(50 reference statements)

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“…The high prevalence of vitamin D insufficiency observed in this study is in accordance with prior international (11)(12)(13)(14)(15) and American (16)(17)(18) reports and affirms the importance of incorporating vitamin D evaluation and therapy recommendations into the design of fracture care pathways. Further interventions may be needed to ensure continued use of supplements, shown to be efficacious for musculoskeletal health (25).…”

Section: Discussionsupporting

confidence: 90%

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Importance of vitamin D in hospital-based fracture care pathways

Glowacki

LeBoff

Kolatkar

et al. 2008

The Journal of nutrition, health and aging

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Objectives-This project was developed to identify ways to support hospital-based improvements for the identification and management of osteoporosis following treament of a fragility fracture.Design-This is a retrospective review of medical records of sets of consecutive patients who were admitted for surgical treatment of fragility fracture following introduction of several versions of admission and discharge care pathways. Effectiveness of the admission pathway was defined as % subjects with measurement of serum 25-hydroxyvitamin D (25(OH)D) during hospitalization; effectiveness of the discharge pathway was defined as % subjects with documentation of instructions for calcium and/or vitamin D supplementation.Setting-This study reviewed medical records of patients admitted to hospital for surgical treatment of a fragility fracture.Participants-Medical records were evaluated for 98 patients older than 50-years who were admitted with a fragility fracture of the hip or femur. Conclusion-The high prevalence of vitamin D insufficiency (78%) observed in this study affirms the importance of incorporating vitamin D supplementation in hospital-based fracture care pathways. The discharge pathway was more effective than the newer admission pathway, a finding attributable to effects of familiarity, retraining, and introduction of computer-prompts. These evolving pathways represent a much-needed paradigm shift in the care of fragility fracture patients. Measurements-Medical

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Section: Discussionsupporting

confidence: 90%

“…Vitamin D-deficiency and insufficiency have been identified in international studies of fracture patients (11)(12)(13)(14)(15). In a recent evaluation of United States community-living postmenopausal women with hip fracture, we reported that 50% of them had extreme vitamin D-deficiency (≤ 12 ng/mL or 30 nmoles/L) (16).…”

Section: Introductionmentioning

confidence: 89%

Importance of vitamin D in hospital-based fracture care pathways

Glowacki

LeBoff

Kolatkar

et al. 2008

The Journal of nutrition, health and aging

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“…23 We did not find any difference in the 25(OH)D levels between patients with femoral neck and trochanteric fractures, in agreement with a previously published study. 24 In contrast, a study done in Crete found that patients with trochanteric fractures had lower levels of 25(OH)D. 4 An excess of trochanteric over femoral neck fractures was found in patients with hypovitaminosis D and secondary hyperparathyroidism, compared to those with "functional hypoparathyroidism," a condition characterized by vitamin D deficiency with no evidence of adequate parathyroid response. 25 Although we found a significant negative correlation between 25(OH)D and iPTH levels in both groups of fracture patients, the prevalence of both secondary hyperparathyroidism and "functional hypoparathyroidism" in patients with insufficient or deficient 25(OH)D levels was quite similar between the two types of fracture patients.…”

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

confidence: 85%

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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“…In both Sydney and New York City, more hip fractures occur in colder months than warmer months, 16,17 whereas studies in Perth have shown that 25OHD levels in patients with hip fractures were related to ambient sunshine and to ambient sunshine exposure in the 2 months before fracture. 18 Taken together, these studies suggest that low 25OHD status associated with reduced UV radiation in colder months increases the risks of falls and hip fracture and may account, in part, for the effectiveness of the combination of vitamin D and calcium on the prevention of hip fracture. 19 Because Western Australia has a Mediterranean climate, the seasonal variation in the 25OHD level demonstrated in the present study is likely to be amplified in other, less congenial climates.…”

Section: Commentmentioning

confidence: 95%