Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain.
Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.
J Endocrinol Invest. 2024 Jun;47(6):1323-1334. doi: 10.1007/s40618-023-02266-2. Epub 2023 Dec 19.
Vitamin D deficiency is common in patients with hip fractures and may negatively affect functional recovery and quality of life (QOL).
This study aimed to conduct a meta-analysis to quantify the effects of vitamin D deficiency on physical function and quality of life after hip fractures.
The PubMed, EMBASE, Scopus, and Cochrane Library databases were searched for relevant studies. The inclusion criteria were hip fracture, comparison between vitamin D deficiency and normal vitamin D levels in patients with hip fracture, and functional outcome as the primary outcome. The exclusion criteria were case reports, reviews, duplicates, studies with a high risk of bias, and non-comparable or missing data. Two independent reviewers selected studies, extracted data, assessed bias, and performed meta-analyses using the Review Manager. Heterogeneity and publication bias were also assessed. Two independent reviewers selected the studies, extracted data, and assessed the risk of bias. We performed a meta-analysis using Review Manager and assessed heterogeneity and publication bias.
Seven studies with 1,972 patients were included. Vitamin D deficiency was defined as a 25(OH)D level < 20 ng/mL. There were no significant differences in the ability to walk (OR 0.68, 95% CI 0.31-1.53, I = 69%) or length of hospital stay (MD 2.27 days, 95% CI - 2.47 to 7.01, I = 93%) between patients with and without vitamin D deficiency. However, patients with vitamin D deficiency had significantly worse functional ability and quality of life (SMD - 1.50, 95% CI - 2.88 to - 0.12, I = 96%).
Despite the limitations of this study, such as small sample size, heterogeneous outcome assessments, and variable vitamin D measurement techniques, the results demonstrated that screening for vitamin D status and optimizing levels through supplementation could facilitate rehabilitation, promote lifestyle changes, aid in the recovery of independence, and help reduce long-term burdens.
维生素 D 缺乏在髋部骨折患者中很常见,可能会对功能恢复和生活质量(QOL)产生负面影响。
本研究旨在进行荟萃分析,以量化维生素 D 缺乏对髋部骨折后身体功能和生活质量的影响。
检索 PubMed、EMBASE、Scopus 和 Cochrane 图书馆数据库,以寻找相关研究。纳入标准为髋部骨折,比较髋部骨折患者中维生素 D 缺乏与正常维生素 D 水平,以及主要结局为功能结局。排除标准为病例报告、综述、重复研究、偏倚风险高的研究、不可比较或缺失数据的研究。两位独立的评审员选择研究、提取数据、评估偏倚,并使用 Review Manager 进行荟萃分析。还评估了异质性和发表偏倚。两位独立的评审员选择了研究,提取了数据,并评估了偏倚风险。我们使用 Review Manager 进行了荟萃分析,并评估了异质性和发表偏倚。
纳入了 7 项研究,共 1972 名患者。维生素 D 缺乏定义为 25(OH)D 水平<20ng/mL。维生素 D 缺乏组和无缺乏组在行走能力(OR 0.68,95%CI 0.31-1.53,I=69%)或住院时间(MD 2.27 天,95%CI-2.47 至 7.01,I=93%)方面无显著差异。然而,维生素 D 缺乏的患者功能能力和生活质量明显较差(SMD-1.50,95%CI-2.88 至-0.12,I=96%)。
尽管本研究存在样本量小、结局评估异质性以及维生素 D 测量技术多样等局限性,但结果表明,筛查维生素 D 状态并通过补充优化水平可能有助于康复,促进生活方式改变,有助于恢复独立性,并有助于减轻长期负担。