Millward David, Root Allison D, Dubois Jeremy, Cohen Randall P, Valdivia Luis, Helming Bruce, Kokoskie Justin, Waterbrook Anna L, Paul Stephen
University of Arizona, Tucson, Arizona, USA.
Orthop J Sports Med. 2020 Dec 9;8(12):2325967120966967. doi: 10.1177/2325967120966967. eCollection 2020 Dec.
Low vitamin D levels along with high-intensity athletic training may put an athlete at increased risk for a stress fracture.
To assess whether supplementation with vitamin D is associated with a reduced risk of stress fractures in college athletes. We also assessed differences in vitamin D levels among athletes participating in outdoor versus indoor sports.
Cohort study; Level of evidence, 2.
The study participants included 802 National Collegiate Athletic Association Division I intercollegiate athletes (497 men and 305 women) on a sports team for at least 1 semester from 2012 to 2018. All athletes who had a baseline vitamin D level in their medical record were included. Athletes with vitamin D levels <40 ng/mL were given vitamin D supplements. We assessed differences in the rate of stress fracture among those who maintained or improved vitamin D levels to ≥40 ng/mL and those who did not, as well as differences in average baseline vitamin D levels by sport type (indoor vs outdoor).
The rate of stress fracture was 12% higher (95% CI, 6-19; < .001) for those who remained low in vitamin D compared with those who were low at baseline but improved their vitamin D status to ≥40 ng/mL. The rate of stress fracture was also 12% higher (95% CI, 5-18; < .001) for those who had low vitamin D levels compared with those who maintained normal levels. The mean baseline vitamin D values were significantly higher for men participating in outdoor sports versus indoor sports. For men, the mean vitamin D level was 5.7 ng/mL higher (95% CI, 0.9-10.5; = .01) in outdoor athletes. For women, the mean vitamin D level was 3.7 ng/mL higher (95% CI, -0.58 to 8.03; < .04) for outdoor versus indoor sports.
Study results indicated that correcting low serum vitamin D levels reduces the risk of stress fracture. This study also presented evidence that athletes who participate in indoor sports may be at greater risk for vitamin D deficiency than those who compete in outdoor sports.
维生素D水平低以及高强度的运动训练可能会增加运动员应力性骨折的风险。
评估补充维生素D是否与降低大学生运动员应力性骨折的风险相关。我们还评估了参加户外运动与室内运动的运动员之间维生素D水平的差异。
队列研究；证据等级，2级。
研究参与者包括802名2012年至2018年期间在运动队至少参加1个学期的美国国家大学体育协会第一分区的大学生运动员（497名男性和305名女性）。所有在病历中有基线维生素D水平记录的运动员都被纳入。维生素D水平<40 ng/mL的运动员给予维生素D补充剂。我们评估了维生素D水平维持或提高到≥40 ng/mL的运动员与未达到该水平的运动员之间应力性骨折发生率的差异，以及不同运动类型（室内与室外）的平均基线维生素D水平的差异。
与基线时维生素D水平低但后来提高到≥40 ng/mL的运动员相比，维生素D水平仍然较低的运动员应力性骨折发生率高12%（95%可信区间，6-19；P<.001）。与维生素D水平维持正常的运动员相比，维生素D水平低的运动员应力性骨折发生率也高12%（95%可信区间，5-18；P<.001）。参加户外运动的男性的平均基线维生素D值显著高于参加室内运动的男性。对于男性，户外运动运动员的平均维生素D水平比室内运动运动员高5.7 ng/mL（95%可信区间，0.9-10.5；P=.01）。对于女性，户外运动与室内运动相比，平均维生素D水平高3.7 ng/mL（95%可信区间，-0.58至8.03；P<.04）。
研究结果表明，纠正血清维生素D水平低可降低应力性骨折的风险。本研究还提供了证据，表明参加室内运动的运动员比参加户外运动的运动员维生素D缺乏的风险可能更大。
