Ramason Rani, Selvaganapathi Natesan, Ismail Noor Hafizah Binte, Wong Wei Chin, Rajamoney Ganesan Naidu, Chong Mei Sian
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Geriatr Orthop Surg Rehabil. 2014 Jun;5(2):82-6. doi: 10.1177/2151458514528952.
Vitamin D deficiency is common in older adults in Western countries with seasonal winters, when the amount of sunlight is much reduced. There is a paucity of data on the prevalence of vitamin D deficiency in patients with hip fracture in countries such as Singapore where the climate is predominantly tropical.
In this study, our aims were to ascertain the prevalence of vitamin D deficiency and risk factors associated with vitamin D deficiency in hospitalized elderly patients with hip fracture in Singapore.
We prospectively studied 485 patients with hip fracture admitted to the orthopedic department over a 1-year period. Nonfragility fractures and younger patients (patients <60 years and those with high-impact injuries) were excluded. Data on patient demographics, comorbidities, functional status, and serum 25-hydroxyvitamin D3 levels were collected. Vitamin D deficiency was defined using Holick classification.
Vitamin D levels were available for 412 patients. Vitamin D deficiency was present in 57.5% (n = 237). Prevalence of vitamin D insufficiency was 34.5%, with only 8% of patients having normal vitamin D levels. Univariate analyses showed Malay race and functional factors (being housebound, requiring bathing and dressing assistance) to be associated with vitamin D deficiency. However, only ethnicity and housebound patients were significant in the multivariate model.
Vitamin D deficiency and insufficiency are common in patients with hip fracture in Singapore. Vitamin D deficiency was associated with being housebound and those of Malay ethnicity. Clothing habits resulting in reduced sunlight exposure may increase the risk of vitamin D deficiency.
在冬季日照量大幅减少的西方国家，老年人维生素D缺乏情况较为普遍。在气候主要为热带的新加坡等国家，关于髋部骨折患者维生素D缺乏患病率的数据较少。
在本研究中，我们旨在确定新加坡住院老年髋部骨折患者中维生素D缺乏的患病率以及与维生素D缺乏相关的危险因素。
我们前瞻性地研究了在1年期间骨科收治的485例髋部骨折患者。排除非脆性骨折患者以及年轻患者（年龄<60岁的患者和高能量损伤患者）。收集患者人口统计学、合并症、功能状态和血清25-羟基维生素D3水平的数据。采用霍利克分类法定义维生素D缺乏。
412例患者有维生素D水平数据。维生素D缺乏患者占57.5%（n = 237）。维生素D不足的患病率为34.5%，只有8%的患者维生素D水平正常。单因素分析显示，马来族裔和功能因素（居家、需要洗澡和穿衣协助）与维生素D缺乏有关。然而，在多因素模型中，只有种族和居家患者具有统计学意义。
在新加坡，髋部骨折患者中维生素D缺乏和不足情况较为常见。维生素D缺乏与居家以及马来族裔有关。导致日照减少的着装习惯可能会增加维生素D缺乏的风险。
