Department of Nutrition, University of Gondar Teaching Hospital, Gondar, Ethiopia.
Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nutr J. 2017 Sep 5;16(1):54. doi: 10.1186/s12937-017-0277-y.
Currently, Vitamin D deficiency is a major public health problem and it affects more than one billion people worldwide. Vitamin D is crucial for bone mineralization and ossification. Patients with fractures need Vitamin D for the healing of their fractured bone. The current study was carried out to determine if there is change in the serum level of Vitamin-D associated with factors at early phase of fractured bone healing (ossification) process among adult fractured patients at University of Gondar teaching hospital, Northwest Ethiopia.
This facility-based prospective follow up study was conducted from March to June 2016. Data was collected by an interviewer, and pretested and structured questionnaires were used. Biological samples were collected to determine the serum level of vitamin-D in all subjects. In addition, X-Ray findings were used to determine the early phase of bone healing process. Data was entered into EPI INFO version 3.5.3 and analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Both bivariate and multivariate logistic regression analysis was done to screen for factors associated with decreased serum levels of Vitamin-D. In the Multivariate regression analysis, those variables which had a P-value of <0.05 were considered as independently associated with change in serum level of Vitamin-D.
A total of 118 adult patients with fractures participated in this study. The prevalence of patients' with decreased serum levels of vitamin-D at post-test was 63.6% [95% CI; (0.551-0.720)]. Inadequate intake of milk and milk products in the 1st week of fracture [AOR = 95%CI: 0.20 (0.05-0.90)], Poor Dietary Diversity Score [AOR = 95% CI: 29.1 (2.27-371.65)], and ossified bone [AOR =95% CI: 4.10 (1.12-14.95)] showed statistically significant association with decreased serum level of Vitamin-D.
Decreased serum level of Vitamin-D at early phase of fractured bone healing process was found in the majority of patients (>63%) raising concern for Vitamin D deficiency to be a significant public health problem in the study population. It was statistically associated with: poor dietary diversity score, in adequate intake of milk and milk products in the 1one week of fracture and ossified (healed) bone. Introducing hospital based Vitamin-D supplementation and integrated with health and nutritional education is a vital intervention needed to improve serum levels of Vitamin-D.
目前，维生素 D 缺乏是一个主要的公共卫生问题，影响着全球超过 10 亿人。维生素 D 对骨骼矿化和骨化至关重要。骨折患者的骨折愈合需要维生素 D。本研究旨在确定在埃塞俄比亚贡德尔大学教学医院的成年骨折患者的骨折骨愈合（骨化）早期阶段，与血清维生素 D 水平相关的因素是否发生变化。
本基于设施的前瞻性随访研究于 2016 年 3 月至 6 月进行。数据由访谈者收集，使用预测试和结构化问卷。对所有受试者采集生物样本以确定血清维生素 D 水平。此外，X 射线检查结果用于确定骨愈合过程的早期阶段。数据输入 EPI INFO 版本 3.5.3 并使用统计软件包（SPSS）版本 20 进行分析。进行了单变量和多变量逻辑回归分析，以筛选与血清维生素 D 水平降低相关的因素。在多变量回归分析中，那些 P 值<0.05 的变量被认为与血清维生素 D 水平的变化独立相关。
共有 118 名成年骨折患者参与了这项研究。在随访时，维生素 D 血清水平降低的患者比例为 63.6%[95%CI；（0.551-0.720）]。骨折后第 1 周摄入牛奶和奶制品不足[AOR 95%CI：0.20（0.05-0.90）]、不良饮食多样性评分[AOR 95%CI：29.1（2.27-371.65）]和骨化（愈合）骨[AOR=95%CI：4.10（1.12-14.95）]与血清维生素 D 水平降低有统计学显著关联。
在骨折骨愈合早期阶段，大多数患者（>63%）的血清维生素 D 水平降低，这引起了对维生素 D 缺乏症的关注，认为这是研究人群中的一个重大公共卫生问题。它与以下因素有统计学关联：不良饮食多样性评分、骨折后第 1 周摄入牛奶和奶制品不足以及骨化（愈合）骨。在医院引入维生素 D 补充剂并与健康和营养教育相结合，是改善维生素 D 血清水平所必需的重要干预措施。
