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日本人群中髋部脆性骨折老年患者维生素D缺乏及不足情况

Insufficiency and deficiency of vitamin D in elderly patients with fragility fractures of the hip in the Japanese population.

作者信息

Niikura Takahiro, Oe Keisuke, Sakai Yoshitada, Iwakura Takashi, Fukui Tomoaki, Nishimoto Hanako, Hayashi Shinya, Matsumoto Tomoyuki, Matsushita Takehiko, Maruo Akihiro, Yagata Yukihisa, Kishimoto Kenta, Sakurai Atsushi, Kuroda Ryosuke

机构信息

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019877517. doi: 10.1177/2309499019877517.

Abstract

BACKGROUND

Data of vitamin D sufficiency in Asian patients with osteoporotic fragility hip fractures are limited. This study aimed to obtain data from the Japanese population.

METHODS

Patients aged 60 years or older with hip fractures were prospectively enrolled. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured. Levels were compared between patients receiving and not receiving treatment for osteoporosis, those with and without previous contralateral hip fractures, and those with femoral neck versus trochanteric fractures. Sex-based differences were also assessed. The serum levels in patients younger than 60 years with extremity fractures were assessed, and differences between elderly and younger patients were evaluated. The individual correlation between 25(OH)D levels and the ultraviolet (UV) index and age was analyzed in elderly patients with hip fractures.

RESULTS

The data of 360 patients (aged 84.7 ± 8.2 years), comprising 80 men and 280 women, were analyzed. The mean 25(OH)D level was 16.5 ± 7.2 ng/mL. The prevalence of vitamin D insufficiency (25(OH)D <30 ng/mL) and deficiency (25(OH)D <20 ng/mL) was 93.9% and 71.7%, respectively. A significant difference was noted in the prevalence of vitamin D deficiency between patients with and without previous contralateral hip fractures. Age and 25(OH)D levels were found to be correlated, with no correlation between the UV index and the 25(OH)D levels. The 25(OH)D level in the younger population ( = 123) was 20.7 ± 8.6 ng/mL, which was significantly higher than that of the elderly.

CONCLUSION

Perennial vitamin D insufficiency is prevalent in elderly Japanese patients with hip fractures.

摘要

背景

亚洲骨质疏松性脆性髋部骨折患者维生素D充足的数据有限。本研究旨在获取来自日本人群的数据。

方法

前瞻性纳入60岁及以上髋部骨折患者。检测血清25-羟基维生素D(25(OH)D)水平。比较接受和未接受骨质疏松治疗的患者、有和无既往对侧髋部骨折的患者以及股骨颈骨折与转子间骨折患者的25(OH)D水平。还评估了性别差异。评估了60岁以下肢体骨折患者的血清水平,并评估了老年患者与年轻患者之间的差异。分析了老年髋部骨折患者25(OH)D水平与紫外线(UV)指数和年龄之间的个体相关性。

结果

分析了360例患者(年龄84.7±8.2岁)的数据,其中男性80例,女性280例。25(OH)D平均水平为16.5±7.2 ng/mL。维生素D不足(25(OH)D<30 ng/mL)和缺乏(25(OH)D<20 ng/mL)的患病率分别为93.9%和71.7%。有和无既往对侧髋部骨折的患者在维生素D缺乏患病率上存在显著差异。发现年龄与25(OH)D水平相关,而UV指数与25(OH)D水平之间无相关性。较年轻人群(n = 123)的25(OH)D水平为20.7±8.6 ng/mL,显著高于老年人群。

结论

常年维生素D不足在老年日本髋部骨折患者中普遍存在。

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