Maier G S, Seeger J B, Horas K, Roth K E, Kurth A A, Maus U
Justus-Liebig-University, Giessen, Germany.
ANZAC Research Institute , University of Sydney, Australia.
Bone Joint J. 2015 Jan;97-B(1):89-93. doi: 10.1302/0301-620X.97B1.34558.
Hypovitaminosis D has been identified as a common risk factor for fragility fractures and poor fracture healing. Epidemiological data on vitamin D deficiency have been gathered in various populations, but the association between vertebral fragility fractures and hypovitaminosis D, especially in males, remains unclear. The purpose of this study was to evaluate serum levels of 25-hydroxyvitamin D (25-OH D) in patients presenting with vertebral fragility fractures and to determine whether patients with a vertebral fracture were at greater risk of hypovitaminosis D than a control population. Furthermore, we studied the seasonal variations in the serum vitamin D levels of tested patients in order to clarify the relationship between other known risk factors for osteoporosis and vitamin D levels. We measured the serum 25-OH D levels of 246 patients admitted with vertebral fractures (105 men, 141 female, mean age 69 years, sd 8.5), and in 392 orthopaedic patients with back pain and no fractures (219 men, 173 female, mean age 63 years, sd 11) to evaluate the prevalence of vitamin D insufficiency. Statistical analysis found a significant difference in vitamin D levels between patients with vertebral fragility fracture and the control group (p = 0.036). In addition, there was a significant main effect of the tested variables: obesity (p < 0.001), nicotine abuse (p = 0.002) and diabetes mellitus (p < 0.001). No statistical difference was found between vitamin D levels and gender (p = 0.34). Vitamin D insufficiency was shown to be a risk factor for vertebral fragility fractures in both men and women.
维生素D缺乏已被确认为脆性骨折和骨折愈合不良的常见危险因素。关于维生素D缺乏的流行病学数据已在不同人群中收集,但椎体脆性骨折与维生素D缺乏之间的关联,尤其是在男性中,仍不明确。本研究的目的是评估椎体脆性骨折患者的血清25-羟基维生素D(25-OH D)水平,并确定椎体骨折患者维生素D缺乏的风险是否高于对照组。此外,我们研究了受试患者血清维生素D水平的季节性变化,以阐明骨质疏松症其他已知危险因素与维生素D水平之间的关系。我们测量了246例因椎体骨折入院患者(105例男性,141例女性,平均年龄69岁,标准差8.5)以及392例有背痛但无骨折的骨科患者(219例男性,173例女性,平均年龄63岁,标准差11)的血清25-OH D水平,以评估维生素D不足的患病率。统计分析发现,椎体脆性骨折患者与对照组之间的维生素D水平存在显著差异(p = 0.036)。此外,受试变量存在显著的主效应:肥胖(p < 0.001)、尼古丁滥用(p = 0.002)和糖尿病(p < 0.001)。维生素D水平与性别之间未发现统计学差异(p = 0.34)。维生素D不足被证明是男性和女性椎体脆性骨折的危险因素。