Sakuma Mayumi, Endo Naoto, Hagino Hiroshi, Harada Atsushi, Matsui Yasumoto, Nakano Tetsuo, Nakamura Kozo
Department of Physical Therapy, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan.
J Orthop Sci. 2011 Jul;16(4):418-23. doi: 10.1007/s00776-011-0089-4. Epub 2011 May 19.
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.
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.
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.
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.
血清25-羟基维生素D（25(OH)D）用作反映维生素D水平的指标。我们之前基于在新潟佐渡岛的一项研究报告称，髋部骨折患者的血清25(OH)D水平低于非髋部骨折病例。在本研究中，对日本四个地区的髋部骨折病例的血清25(OH)D状况进行了检查。尽管大多数髋部骨折患者既往有过脊柱压缩性骨折，但这些骨折与25(OH)D之间的关系尚不清楚。因此，我们还在相同地点和时间段内检查了脊柱压缩性骨折患者的25(OH)D水平。
对日本几个地区因骨质疏松症导致髋部和脊柱骨折的患者进行了25(OH)D、完整甲状旁腺激素（完整PTH）、未羧化骨钙素（ucOC）、尿I型胶原N端交联肽（NTX）水平以及骨密度的检测。
各地区之间在年龄、体重指数、血清25(OH)D、血清完整PTH和血清ucOC方面无显著差异。髋部骨折和脊柱骨折患者的血清25(OH)D水平较低。髋部骨折患者的平均血清25(OH)D水平显著低于脊柱骨折患者（16.3对18.1 ng/mL，P<0.05）。37%的髋部骨折患者和44%的脊柱骨折患者存在高血清ucOC。
髋部和脊柱骨折患者均存在维生素D不足，在日本四个地区的老年患者中发现了类似结果。这种情况在髋部骨折患者中往往比脊柱骨折患者更严重。
