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Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies

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Abstract

Background

Vitamin D deficiency is common in patients with hip fractures and may negatively affect functional recovery and quality of life (QOL).

Objective

This study aimed to conduct a meta-analysis to quantify the effects of vitamin D deficiency on physical function and quality of life after hip fractures.

Methods

The PubMed, EMBASE, Scopus, and Cochrane Library databases were searched for relevant studies. The inclusion criteria were hip fracture, comparison between vitamin D deficiency and normal vitamin D levels in patients with hip fracture, and functional outcome as the primary outcome. The exclusion criteria were case reports, reviews, duplicates, studies with a high risk of bias, and non-comparable or missing data. Two independent reviewers selected studies, extracted data, assessed bias, and performed meta-analyses using the Review Manager. Heterogeneity and publication bias were also assessed. Two independent reviewers selected the studies, extracted data, and assessed the risk of bias. We performed a meta-analysis using Review Manager and assessed heterogeneity and publication bias.

Results

Seven studies with 1,972 patients were included. Vitamin D deficiency was defined as a 25(OH)D level < 20 ng/mL. There were no significant differences in the ability to walk (OR 0.68, 95% CI 0.31–1.53, I2 = 69%) or length of hospital stay (MD 2.27 days, 95% CI − 2.47 to 7.01, I2 = 93%) between patients with and without vitamin D deficiency. However, patients with vitamin D deficiency had significantly worse functional ability and quality of life (SMD − 1.50, 95% CI − 2.88 to − 0.12, I2 = 96%).

Conclusions

Despite the limitations of this study, such as small sample size, heterogeneous outcome assessments, and variable vitamin D measurement techniques, the results demonstrated that screening for vitamin D status and optimizing levels through supplementation could facilitate rehabilitation, promote lifestyle changes, aid in the recovery of independence, and help reduce long-term burdens.

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Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain

    R. Llombart

  2. Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain

    G. Mariscal, C. Barrios & R. Llombart-Ais

  3. Department of Basic Medical Sciences, Catholic University of Valencia, 46001, Valencia, Spain

    J. E. de la Rubia Ortí

  4. Traumacenter, Casa de Salud Hospital, Valencia, Spain

    R. Llombart-Ais

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Contributions

Conception and design: RL, GM, JEdlR, CB, RLA; Analysis and interpretation of the data: RL, GM, JEdlR, CB, RLA; Drafting of the article: RL, GM, CB, RLA; Critical revision of the article for important intellectual content: CB; Final approval of the article: RL, GM, JEdlR, CBRLA; Statistical expertise: RL, GM, JEdlR, CB RLA; Collection and assembly of data: RL, GM, JEdlR, CBRLA

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Correspondence to G. Mariscal.

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Llombart, R., Mariscal, G., Barrios, C. et al. Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies. J Endocrinol Invest 47, 1323–1334 (2024). https://doi.org/10.1007/s40618-023-02266-2

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