Abstract
Background
Serum 25-hydroxyvitamin D (25(OH)D) is used as an index that reflects the level of vitamin D. We have previously reported, on the basis of a study in Sado in Niigata, that patients with hip fracture have lower serum 25(OH)D levels than non-hip-fracture cases. In this study, the serum 25(OH)D status in hip-fracture cases was examined in four regions in Japan. Although most hip-fracture patients have experienced past spine-compression fractures, the relationship of these fractures and 25(OH)D is unknown. Therefore, we also examined the 25(OH)D level in spine-compression fracture patients in the same locations and time periods.
Methods
The levels of 25(OH)D, intact parathyroid hormone (intact PTH), undercarboxylated osteocalcin (ucOC), urine N-terminal crosslinking telopeptide of type I collagen (NTX), and bone mineral density were examined in patients with hip and spine fracture due to osteoporosis in several regions in Japan.
Results
There were no significant differences in age, BMI, serum 25(OH)D, serum intact PTH, and serum ucOC among the regions. Levels of serum 25(OH)D were low in patients with hip fracture and spine fracture. The average serum 25(OH)D level was significantly lower in hip-fracture patients than in spine-fracture patients (16.3 vs. 18.1 ng/mL, P < 0.05). High serum ucOC was found in 37% of hip-fracture patients and 44% of spine-fracture patients.
Conclusions
Both hip and spine-fracture patients have vitamin D insufficiency, with similar results found in elderly patients in four areas of Japan. The severity of this condition tends to be more serious in hip-fracture patients than in spine-fracture patients.
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Acknowledgments
We thank the orthopedic departments of the institutions that contributed to this study. We are especially grateful to Drs M Takemura, Y Terabe and T Hida, National Center for Geriatrics and Gerontology, Dr M Shimizu, Shimizu Hospital, Dr M Nakashima, Nojima Hospital, and Drs A Hattori and T Oinuma, Sado General Hospital, for their cooperation. The study could not have been completed without the assistance of all the orthopedic surgeons and numerous other health-care professionals. We express our gratitude to all the individuals who assisted with the study. We also thank Dr Naohito Tanabe, Department of Public Health, Niigata University Graduate School of Medical and Dental Sciences, for advice on statistical analysis. This study was funded by the Committee on Osteoporosis of the Japan Orthopedic Association (we especially thank Drs K Sakamoto, E Ihi, K Aoyagi, K Kita, K Yamazaki, N Yamamoto, T Nakamura, and R Toyoshima) and partially supported by a grant-in-aid from the Ministry of Health, Labor and Welfare of Japan (grant H18-Choujyu Ippann-036).
Conflict of interest
The authors did not receive and will not receive any benefits and funding from any commercial party related directly or indirectly to the subject of this article.
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Sakuma, M., Endo, N., Hagino, H. et al. Serum 25-hydroxyvitamin D status in hip and spine-fracture patients in Japan. J Orthop Sci 16, 418–423 (2011). https://doi.org/10.1007/s00776-011-0089-4
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DOI: https://doi.org/10.1007/s00776-011-0089-4