The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis

Abstract

Background: The incidence of osteoporotic fractures has increased rapidly, and because of the poor prognosis and high mortality associated with osteoporotic fractures, they remain a prospective research area globally. One way to reduce their incidence is to investigate their intervention risk factors in the elderly. Hence, this study explores the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and osteoporotic fractures in elderly patients through a meta-analysis. Methods: We conducted our literature search mainly in PubMed and Embase for identifying studies that investigated the relationship between serum 25(OH)D levels and the risk for osteoporotic fractures. We performed categorical analysis, heterogeneity checks, publication bias analysis, and subgroup analyses. Results: In total, 20 studies were included, of which 4 were case-cohort studies and 16 were cohort studies. A total of 41,738 patients from 20 studies were included in the meta-analysis, of which 5916 had fractures, including 3237 hip fractures. By combining the lowest and highest categories of relative risks (RRs) and 95% confidence intervals (CIs), it was suggested that lower serum 25-hydroxyvitamin D levels may be a risk factor for fractures. RR (95% CI) for total and hip fractures were 1.11 (0.99, 1.24) and 0.89 (0.80, 0.98) after adjustments. Conclusions: Our study showed that compared to low serum 25(OH)D levels, high serum 25(OH)D levels reduce the risk of hip fractures in the patients aged 60 years or older. In contrast, serum 25(OH)D has no significant relationship with total fracture risk.

How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture?

“…Vitamin D insufficiency or deficiency was also common across all age groups in two cohorts of patients undergoing fracture repair surgery [ 51 ]. In a meta-analysis exploring the correlation between serum 25(OH)D levels and osteoporotic fractures in elderly, high as compared to low serum 25(OH)D levels were associated with reduced risk of hip fracture but had no significant relationship with total fracture risk [ 52 ]. Vitamin D deficiency may contribute to the pathogenesis of fragility fracture through altered bone strength and increasing fall risk and indeed may also be relevant for post-fracture recovery (Fig.…”

New Roles for Vitamin D Superagonists: From COVID to Cancer

“…High serum levels were associated with a reduced risk of hip fractures in elderly patients, but not with reduction in total fracture risk. The authors suggested that disparate results seen in earlier studies may have arisen due to selection of fracture sites studied and analysis of both perimenopausal and senile osteoporotic fractures ( 59 ).…”

In reply to the letter to the editor regarding “The Relationship Between Serum Vitamin D and Fracture Risk in the Elderly: A Meta-Analysis”

“…We wish to thank all of the reviewers for their thought-provoking and insightful comments about our recent meta-analysis published in the journal [ 1 ]. Our answers to the questions raised are as follows:…”