Williams Kevin, Askew Christian, Mazoue Christopher, Guy Jeffrey, Torres-McGehee Toni M, Jackson Iii J Benjamin
University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA.
University of South Carolina School of Public Health, Columbia, SC, USA.
Orthop Res Rev. 2020 Feb 27;12:9-17. doi: 10.2147/ORR.S233387. eCollection 2020.
Vitamin D is paramount to bone health and little is known about vitamin D's role in the prevention of stress fractures in high-risk athletes. This study consists of a prospective, cross-sectional analysis accompanied by a retrospective review for control comparison of vitamin D3 supplementation in high-risk athletes. Our hypothesis is that supplemental vitamin D3 treatment will decrease the occurrence of stress fractures in high-risk collegiate athletes.
A total of 118 NCAA Division I athletes were recruited from 6 high-risk collegiate teams. Blood draws in August and February established baseline 25(OH)D levels. Subjects with serum 25(OH)D <30 ng/mL were supplemented with 50,000 IU of vitamin D3/week for 8 weeks. Treated subjects were re-tested to ensure serum 25(OH)D levels rose to sufficient status. All enrolled subjects were monitored for the development of stress fractures. A 5-year retrospective chart review of athletes from the same sports teams was conducted to determine the incidence of any reported stress fractures in the past.
Prospective: 112 of the 118 enrolled subjects were tested in August. Sixty-one demonstrated vitamin D sufficiency (40.2 ng/mL ±8.28) and 51 were either insufficient or deficient (22.7 ng/mL ±4.89). Of the 118 enrolled subjects, 104 were tested in February. Fifty-six demonstrated vitamin D sufficiency (40.7 ng/mL ±9.47) and 48 were insufficient or deficient (21.6 ng/mL ±5.87). Two stress fractures were diagnosed amongst our cohort of 118 student athletes (1.69%). Retrospective: 34 stress fractures were diagnosed in 453 subjects from 01/2010-05/2015 (7.51%). Amongst our athletic teams, the cross-country team specifically demonstrated a statistically significant decrease in stress fracture incidence (p<0.05). We also found a statistically significant reduction in stress fracture incidence amongst the current overall cohort compared to our retrospective cohort (p<0.05).
In our population, almost half of the tested athletes proved to be vitamin D deficient. Hypovitaminosis D was prevalent throughout the winter months compared with the summer. With vitamin D3 supplementation, the stress fracture rate in our overall cohort demonstrated a statistically significant decrease from 7.51% to 1.65% (p=0.009).
维生素D对骨骼健康至关重要，而关于维生素D在预防高危运动员应力性骨折方面的作用，人们所知甚少。本研究包括一项前瞻性横断面分析，并伴有回顾性研究，以对照比较高危运动员补充维生素D3的情况。我们的假设是，补充维生素D3治疗将降低高危大学运动员应力性骨折的发生率。
从6支高危大学运动队招募了118名美国大学体育协会（NCAA）一级运动员。在8月和2月采血以确定基线25(OH)D水平。血清25(OH)D<30 ng/mL的受试者每周补充50,000 IU维生素D3，持续8周。对接受治疗的受试者进行重新检测，以确保血清25(OH)D水平升至充足状态。对所有入选受试者进行应力性骨折发生情况的监测。对来自同一运动队的运动员进行了为期5年的回顾性病历审查，以确定过去报告的任何应力性骨折的发生率。
前瞻性研究：118名入选受试者中的112名在8月接受了检测。61名维生素D充足（40.2 ng/mL±8.28），51名不足或缺乏（22.7 ng/mL±4.89）。在118名入选受试者中，104名在2月接受了检测。56名维生素D充足（40.7 ng/mL±9.47），48名不足或缺乏（21.6 ng/mL±5.87）。在我们的118名学生运动员队列中诊断出2例应力性骨折（1.69%）。回顾性研究：在2010年1月至2015年5月期间，453名受试者中诊断出34例应力性骨折（7.51%）。在我们的运动队中，越野队应力性骨折发生率有统计学意义的显著下降（p<0.05）。我们还发现，与回顾性队列相比，当前整个队列的应力性骨折发生率有统计学意义的显著降低（p<0.05）。
在我们的研究人群中，近一半接受检测的运动员被证明维生素D缺乏。与夏季相比，维生素D缺乏症在整个冬季都很普遍。通过补充维生素D3，我们整个队列的应力性骨折发生率从7.51%降至1.65%，有统计学意义的显著下降（p=0.009）。
