Zellner Benjamin S, Dawson John R, Reichel Lee M, Schaefer Kayla, Britt Jolie, Hillin Cody, Reitman Charles A
Department of Orthopedic Surgery, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX.
J Orthop Trauma. 2014 Sep;28(9):e210-5. doi: 10.1097/BOT.0000000000000053.
There are several metabolic factors known to be important for the maintenance of bone and muscle function. Causes of deficiency are multifactorial and can include such things as geographic region, latitude, and socioeconomic factors. The purpose of this study was to determine the prevalence of metabolic deficiencies.
Level 1, urban trauma center.
Prospective laboratory evaluation.
The subjects included 652 consecutive admits to the orthopaedic surgery service between July 1, 2011, and June 30, 2012.
Laboratory evaluation.
Metabolic and endocrine profiles included a serum analysis on all patients. Subject data included age, gender, body mass index, month of admission, and type of injury, and subjects' self-reported race, alcohol, recreational drug, and tobacco use were collected.
Six hundred fifty-two subjects with an average age of 41.2 years were evaluated. After data analysis, only 25-hydroxyvitamin D levels were found to be persistently poor across the patient population: 86.2% of subjects were insufficient in 25-hydroxyvitamin D (<30 ng/mL), 53.2% were deficient (<20 ng/mL), and 14.0% had levels <10 ng/mL (severely deficient); 76.7% of the subjects increased skin pigmentation, and the differences in 25-hydroxyvitamin D levels between races were significantly different. African Americans had the highest risk of severe deficiency. 25-Hydroxyvitamin D levels were significantly higher during summer months, with men, and with a lower body mass index, but there were no differences based on age or substance use. Additional laboratory analysis did not reveal significant nutritional deficiency.
The prevalence of hypovitaminosis D is widespread. This may negatively affect outcomes for orthopaedic patients but would be easily correctable. 25-Hydroxyvitamin D serologic analysis should be considered for all orthopaedic trauma patients.
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
已知有几种代谢因素对维持骨骼和肌肉功能很重要。缺乏的原因是多因素的，可能包括地理区域、纬度和社会经济因素等。本研究的目的是确定代谢缺乏的患病率。
一级城市创伤中心。
前瞻性实验室评估。
研究对象包括2011年7月1日至2012年6月30日期间连续收治到骨科手术科室的652名患者。
实验室评估。
代谢和内分泌指标包括对所有患者进行血清分析。收集的受试者数据包括年龄、性别、体重指数、入院月份、损伤类型，以及受试者自我报告的种族、酒精、消遣性药物和烟草使用情况。
对652名平均年龄为41.2岁的受试者进行了评估。数据分析后发现，在整个人群中只有25-羟维生素D水平持续较差：86.2%的受试者25-羟维生素D不足（<30 ng/mL），53.2%缺乏（<20 ng/mL），14.0%的水平<10 ng/mL（严重缺乏）；76.7%的受试者皮肤色素沉着增加，不同种族之间25-羟维生素D水平差异显著。非裔美国人严重缺乏的风险最高。夏季、男性以及体重指数较低者的25-羟维生素D水平显著较高，但在年龄或物质使用方面没有差异。进一步的实验室分析未发现明显的营养缺乏。
维生素D缺乏症的患病率很普遍。这可能会对骨科患者的治疗结果产生负面影响，但很容易纠正。所有骨科创伤患者都应考虑进行25-羟维生素D血清学分析。
预后IV级。有关证据水平的完整描述，请参阅作者指南。
