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Hip fracture patients in India have vitamin D deficiency and secondary hyperparathyroidism

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Abstract

Summary

This study evaluated the parameters of bone mineral homeostasis including 25(OH)D and PTH in 90 Indian patients with hip fracture and 90 controls. Hypovitaminosis D, secondary hyperparathyroidism, and biochemical osteomalacia was present in 77, 69, and 50 % patients, respectively, significantly higher compared to controls. Vitamin D deficiency is an important risk factor for hip fracture.

Introduction

The prevalence of vitamin D deficiency is not well known in hip fracture patients from India. Therefore, the present study was conducted to evaluate the parameters of bone mineral homeostasis including 25(OH)D and intact PTH in hip fracture from North India.

Methods

Ninety consecutive patients with hip fracture and similar number of age- and sex-matched controls were enrolled in the study. The fasting venous samples were analyzed for 25-hydroxyvitamin D (25-OHD), intact parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus. Vitamin D deficiency was defined as serum 25-OHD of <20 ng/dl.

Results

The mean age of hip fracture subjects was 65.9 ± 12.6 which was comparable in men and women. Majority of study subjects were women (70 women and 20 men). The serum 25(OH)D and calcium levels were significantly lower, whereas the intact PTH and ALP levels were significantly higher in patients compared to controls. There was significant negative correlation between serum 25(OH)D and PTH. In the hip fracture group, 76.7 % of the subjects had vitamin D deficiency, and 68.9 % had secondary hyperparathyroidism. In the control group, vitamin D deficiency and elevated PTH levels were seen in 32.3 and 42.2 %, respectively.

Conclusion

About three fourths of hip fracture patients have vitamin D deficiency, and two thirds have secondary hyperparathyroidism. Therefore, the serum 25-OHD level may be a useful index for the assessment of risk of hip fracture in India.

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Authors and Affiliations

  1. Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India, 110002

    D. K. Dhanwal & S. Sahoo

  2. Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India, 110002

    V. K. Gautam

  3. Department of Biostatistics, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India, 110002

    R. Saha

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  1. D. K. Dhanwal
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  4. R. Saha
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Correspondence to D. K. Dhanwal.

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Recipient of the Young Investigator Award during the IOF Regionals, First Asia-Pacific Osteoporosis Meeting held in Singapore in December 2010.

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Dhanwal, D.K., Sahoo, S., Gautam, V.K. et al. Hip fracture patients in India have vitamin D deficiency and secondary hyperparathyroidism. Osteoporos Int 24, 553–557 (2013). https://doi.org/10.1007/s00198-012-1993-y

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  • DOI: https://doi.org/10.1007/s00198-012-1993-y

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