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根据地中海悖论,低能量髋部骨折患者的维生素D缺乏情况

Vitamin D Deficiency in Patients With Low-Energy Hip Fractures in Accordance With the Mediterranean Paradox.

作者信息

Konstantinidis Christos, Psoma Ourania, Kotsias Christos, Panagiotopoulos Vasileios, Plakoutsis Sotiris, Tsiampas Dimitrios, Vardakas Dimitrios, Giotis Dimitrios

机构信息

Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC.

Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, GRC.

出版信息

Cureus. 2024 Apr 4;16(4):e57583. doi: 10.7759/cureus.57583. eCollection 2024 Apr.

DOI:10.7759/cureus.57583
PMID:38707155
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11069122/
Abstract

Introduction Vitamin D deficiency (VDD) is considered one of the leading causes of poor bone quality. It may also be related to severe muscular weakness, especially in the elderly, which leads to frequent falls. Thus, VDD might be associated with fragility fractures of the hip, wrist, and spine in this age category. In this cross-sectional study, our goal was to present vitamin D levels in an elderly Mediterranean population with hip fractures and to assess whether its levels are related to the incidence or prevention of such injuries. Methods Between January and December 2021, 140 patients aged 65 years or older were hospitalized in our department with a fracture involving the hip joint. Serum calcium and vitamin D level control was performed upon admission, as well as recording whether anti-osteoporosis medication had been prescribed. Only patients with low-energy fractures were included, whereas oncologic patients and those with high-energy trauma were excluded. Results Thirty-eight men and 102 women, with a mean age of 83.12 and 84.88 years, respectively, participated in our study. Intertrochanteric fractures were the most common injuries (50.72%). Low vitamin D levels (<30 ng/mL) were observed in 132 patients (94.28%). A bone density scan during the last year had been conducted by only seven patients (5%), whereas in 136 patients (97.14%), no anti-osteoporotic medication was given. Conclusion There is an excessive percentage of aged patients with hip fractures in Greece, demonstrating a significant vitamin D insufficiency despite the high annual frequency of sunny days in this Mediterranean region. Presumably, most of these patients neither perform the routine bone density scan nor do they take any kind of preventive pharmaceutical treatment, which might reveal devaluation of osteoporosis from this age group due to contingent comorbidities.

摘要

引言 维生素D缺乏(VDD)被认为是导致骨质不佳的主要原因之一。它还可能与严重的肌肉无力有关,尤其是在老年人中,这会导致频繁跌倒。因此,VDD可能与该年龄段的髋部、腕部和脊柱脆性骨折有关。在这项横断面研究中,我们的目标是呈现患有髋部骨折的老年地中海人群的维生素D水平,并评估其水平是否与此类损伤的发生或预防有关。

方法 2021年1月至12月期间,140名65岁及以上的患者因髋关节骨折在我们科室住院。入院时进行血清钙和维生素D水平检查,并记录是否开具了抗骨质疏松药物。仅纳入低能量骨折患者,而肿瘤患者和高能量创伤患者被排除。

结果 38名男性和102名女性参与了我们的研究,平均年龄分别为83.12岁和84.88岁。转子间骨折是最常见的损伤(50.72%)。132名患者(94.28%)维生素D水平较低(<30 ng/mL)。仅7名患者(5%)在过去一年进行了骨密度扫描,而136名患者(97.14%)未给予抗骨质疏松药物。

结论 在希腊,髋部骨折的老年患者比例过高,尽管该地中海地区每年晴天频率较高,但仍显示出明显的维生素D不足。据推测,这些患者中的大多数既未进行常规骨密度扫描,也未采取任何预防性药物治疗,这可能揭示了由于偶然的合并症,该年龄组对骨质疏松症的重视不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06cb/11069122/9f701d33ee95/cureus-0016-00000057583-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06cb/11069122/9f701d33ee95/cureus-0016-00000057583-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06cb/11069122/9f701d33ee95/cureus-0016-00000057583-i01.jpg

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