Phusunti Suchat, Suthutvoravut Worasit, Unnanuntana Aasis, Chotiyarnwong Pojchong
J Med Assoc Thai. 2016 Nov;99(11):1233-8.
The proportion of people aged 65 years or older continues to increase in Thailand. Consistent with that trend, the number of fragility fracture patients is increasing. Hypovitaminosis D is one of the important factors associated with fragility fracture.
To evaluate serum 25-hydroxyvitamin D (25(OH)D) level and prevalence of hypovitaminosis D in patients with fragility hip fracture in Thailand.
This study retrospectively reviewed 25(OH)D level in fragility hip fracture patients treated at Siriraj Hospital between January 2012 and December 2015.
Three hundred seventy nine fragility hip fractures were included in this study. Two hundred sixty eight of those patients had serum 25(OH)D level available within one month after fracture. Mean age of patients was 80.8±8.3 years and 74.6% were women. One hundred twenty four patients (46.3%) had vitamin D deficiency (<20 ng/mL) and 86 patients (32.1%) had vitamin D insufficiency (20 to 30 ng/mL). Parathyroid hormone level was available in 159 of 268 patients, and 31.5% of those had hyperparathyroidism (PTH level >65 pg/mL).
Orthopedists who treat fragility hip fracture should always include treatment of vitamin D deficiency in their patient management plan. Future studies should establish treatment guidelines regarding dose and duration of vitamin D supplementation in fragility hip fracture patients.
在泰国,65岁及以上老年人的比例持续上升。与此趋势一致,脆性骨折患者的数量也在增加。维生素D缺乏是与脆性骨折相关的重要因素之一。
评估泰国脆性髋部骨折患者的血清25-羟基维生素D(25(OH)D)水平及维生素D缺乏的患病率。
本研究回顾性分析了2012年1月至2015年12月在诗里拉吉医院接受治疗的脆性髋部骨折患者的25(OH)D水平。
本研究纳入了379例脆性髋部骨折患者。其中268例患者在骨折后1个月内有血清25(OH)D水平数据。患者的平均年龄为80.8±8.3岁,74.6%为女性。124例患者(46.3%)存在维生素D缺乏(<20 ng/mL),86例患者(32.1%)存在维生素D不足(20至30 ng/mL)。268例患者中有159例可获得甲状旁腺激素水平数据,其中31.5%患有甲状旁腺功能亢进(甲状旁腺激素水平>65 pg/mL)。
治疗脆性髋部骨折的骨科医生应在患者管理计划中始终纳入维生素D缺乏的治疗。未来的研究应制定关于脆性髋部骨折患者维生素D补充剂量和疗程的治疗指南。