Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece.
Department of Orthopaedics and Traumatology, 251 HAF - VA Hospital, Athens, Greece.
J Musculoskelet Neuronal Interact. 2021 Mar 1;21(1):93-103.
We examined the role of vitamin D on volumetric bone mineral density (vBMD) and architecture during the first week's post-fracture in postmenopausal women (PMW) with distal radial fractures (DRF) treated conservatively using peripheral Quantitative Computed Tomography (pQCT).
Patients were classified into 2 groups according to initial median 25(OH)D level; Group A (25(OH)D ≥15 ng/ml) and group B (25(OH)D <15 ng/ml). All patients were followed for 12 weeks at three visits: baseline, 6 weeks and 12 weeks post fracture. pQCT was performed at baseline in fractured and contralateral non-fractured radius and at 6 and 12 week on the fractured side.
39 patients completed the protocol. Mean 25(OH)D levels were 15.60±7.35 ng/ml (3.5-41.7). Trabecular (trab) bone mineral content (BMC) and trabvBMD increased at 6 wk. vs. baseline (p<0.001). Cortical BMC, cortvBMD and cross- sectional area (CSA) progressively decreased (p<0.001) during the 12 weeks. There was no interaction between baseline 25(OH)D levels and changes in trabecular and cortical BMC, vBMD and CSA. Advanced age and higher CTX and P1NP were associated with higher cortical bone loss.
Vitamin D deficiency does not affect the early architectural changes after a DRF. Advanced age and higher bone remodeling were associated with higher cortical bone loss, probably related to immobilization and independent of vitamin D levels.
我们研究了维生素 D 对保守治疗的绝经后女性（PMW）桡骨远端骨折（DRF）患者骨折后第 1 周体积骨矿物质密度（vBMD）和骨结构的作用，采用外周定量计算机断层扫描（pQCT）。
根据初始 25（OH）D 中位数水平，将患者分为 2 组；组 A（25（OH）D≥15ng/ml）和组 B（25（OH）D<15ng/ml）。所有患者在骨折后 3 次就诊中进行 12 周随访：基线、6 周和 12 周。在基线时对骨折和对侧非骨折桡骨进行 pQCT 检查，并在 6 和 12 周时对骨折侧进行检查。
39 例患者完成了方案。平均 25（OH）D 水平为 15.60±7.35ng/ml（3.5-41.7）。与基线相比，6 周时骨小梁（trab）骨矿物质含量（BMC）和 trabvBMD 增加（p<0.001）。在 12 周期间，皮质 BMC、cortvBMD 和横截面积（CSA）逐渐减少（p<0.001）。基线 25（OH）D 水平与骨小梁和皮质 BMC、vBMD 和 CSA 的变化之间无相互作用。年龄较大、CTX 和 P1NP 较高与皮质骨丢失较多有关。
维生素 D 缺乏并不影响 DRF 后早期的结构变化。年龄较大和较高的骨重塑与较高的皮质骨丢失有关，这可能与固定有关，与维生素 D 水平无关。
