Charlie Norwood Veterans Administration Medical Center, Augusta, Georgia.
Department of Medicine, Division of Rheumatology, Medical College of Georgia at Augusta University, Augusta, Georgia.
Top Spinal Cord Inj Rehabil. 2024 Winter;30(1):98-112. doi: 10.46292/sci23-00057. Epub 2024 Feb 29.
Osteoporotic fractures occur in almost half of patients with a spinal cord injury (SCI) and are associated with significant morbidity and excess mortality. Paralyzed Veterans Administration (PVA) guidelines suggest that adequate calcium and vitamin D intake is important for skeletal health, however, the association of these supplements with osteoporotic fracture risk is unclear.
To determine the association of filled prescriptions for calcium and vitamin D with fracture risk in Veterans with an SCI.
The 5897 persons with a traumatic SCI of at least 2 years' duration (96% male; 4% female) included in the VSSC SCI/D Registry in FY2014 were followed from FY2014 to FY2020 for incident upper and lower extremity fractures. Filled daily prescriptions for calcium or vitamin D supplements for ≥6 months with an adherence ≥80% were examined.
Filled prescriptions for calcium (hazard ratio [HR] 0.65; 95% CI, 0.54-0.78) and vitamin D (HR 0.33; 95% CI, 0.29-0.38) supplements were associated with a significantly decreased risk for incident fractures.
Calcium and vitamin D supplements are associated with decreased risk of fracture, supporting PVA guidelines that calcium and vitamin D intake are important for skeletal health in persons with an SCI.
骨质疏松性骨折几乎发生在一半以上的脊髓损伤（SCI）患者中，与显著的发病率和死亡率增加有关。瘫痪退伍军人管理局（PVA）指南表明，充足的钙和维生素 D 摄入对骨骼健康很重要，然而，这些补充剂与骨质疏松性骨折风险的关系尚不清楚。
确定脊髓损伤退伍军人中钙和维生素 D 补充剂处方与骨折风险的相关性。
在 FY2014 年 VSSC SCI/D 登记处纳入的 5897 名至少有 2 年病程的创伤性 SCI 患者（96%为男性；4%为女性），从 FY2014 年到 FY2020 年期间随访发生的上肢和下肢骨折事件。检查了钙或维生素 D 补充剂的每日处方，其服用时间≥6 个月且服用依从性≥80%。
钙（危险比 [HR] 0.65；95%置信区间，0.54-0.78）和维生素 D（HR 0.33；95%置信区间，0.29-0.38）补充剂的处方与骨折事件风险显著降低相关。
钙和维生素 D 补充剂与骨折风险降低相关，支持 PVA 指南，即钙和维生素 D 摄入对 SCI 患者的骨骼健康很重要。
