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The associations between serum 25-hydroxyvitamin D level and the risk of total fracture and hip fracture

Osteoporosis International volume 28, pages 1641–1652 (2017)Cite this article

Abstract

Summary

In this meta-analysis, we evaluated the association between serum 25-hydroxyvitamin D (25(OH) vitamin D) level and the risk of total fractures and hip fractures. Low serum 25(OH) vitamin D level is associated with an increased risk of total and hip fractures.

Introduction

Data on the association between serum 25(OH) vitamin D level and the risk of fractures are conflicting. This study aimed to provide a summary of prospective cohort or nested case–control studies on the association between serum 25(OH) vitamin D level and the risk of total fractures and hip fractures.

Methods

We identified relevant studies by searching the PubMed, EMBASE, and OVID databases from their inception to June 1, 2016. We included published prospective cohort or nested case–control studies evaluating the associations of serum 25(OH) vitamin D level with the fracture risk. Two reviewers abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were derived throughout the whole analysis.

Results

Sixteen prospective cohort studies and three nested case–control studies were included. We found that low serum 25(OH) vitamin D level was significantly associated with the risk of total fractures (RR 1.25, 95% CI 1.06–1.43; I 2 = 31.3%, p for heterogeneity = 0.15) and hip fractures (RR 1.48, 95% CI 1.29–1.68; I 2 = 0%, p for heterogeneity = 0.51). The hip fracture risk was increased by 40% for each SD decrease in serum 25(OH) vitamin D level (RR 1.40, 95% CI 1.20–1.61; I 2 = 0%, p for heterogeneity = 0.51). The per SD decrease in serum 25(OH) vitamin D level was not associated with the increased risk of total fractures (RR 1.14, 95% CI 0.93–1.35; I 2 = 63.2%, p for heterogeneity = 0.04).

Conclusions

Our study suggests that low serum 25(OH) vitamin D level is associated with increased risks of total and hip fractures. In the analyzed studies, the per SD decrease in serum 25(OH) vitamin D level was associated with the hip fracture risk but not with the total fracture risk.

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  1. Department of Orthopedics, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China

    Y. Feng, G. Cheng, H. Wang & B. Chen

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  2. G. Cheng
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Feng, Y., Cheng, G., Wang, H. et al. The associations between serum 25-hydroxyvitamin D level and the risk of total fracture and hip fracture. Osteoporos Int 28, 1641–1652 (2017). https://doi.org/10.1007/s00198-017-3955-x

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  • DOI: https://doi.org/10.1007/s00198-017-3955-x

Keywords

  • Cohort
  • Fracture
  • Meta-analysis
  • Serum 25(OH) vitamin D