Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China.
Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China.
J Orthop Surg Res. 2024 Aug 2;19(1):460. doi: 10.1186/s13018-024-04953-z.
Both vitamin C and D deficiencies are extremely common in clinical practice, especially in elderly population. Unfortunately, the role of vitamin C deficiency in osteoporosis related consequences is often neglected. The aim of the present study is to analyse if combined vitamin C and D deficiency would have an association with bone mineral density (BMD) and osteoporotic vertebral fracture (OVF).
Ninety-nine post-menopausal female patients admitted in the department of spine surgery of third affiliated hospital of Sun Yat-sen University were enrolled in the study. The participants were divided into four groups; vitamin D deficiency alone (comparator group), vitamin C deficiency alone and combined vitamin C and D deficiency as experimental group. The levels of vitamin C, vitamin D, calcium, phosphorous, BMD and condition of OVF were analysed.
There were statistically significant differences between the groups in terms of vitamin C and D levels. In terms of lumbar BMD, significant differences were observed between vitamin D deficiency alone and combined vitamin C and D deficiency. Only the combined vitamin C and D deficiency had a significant negative association with lumbar BMD and T-score. Similarly, combined vitamin C and D deficiency had a significant positive association with lumbar osteoporosis. None of the groups had any significant association with OVF. Combined vitamin C and D deficiency was found to be significantly associated with lower lumbar BMD and osteoporosis.
Combined vitamin C and D deficiency results in lower bone mineral density and higher risk of osteoporosis. We believe that existence of deficiencies of both vitamins could have a synergistic effect. Therefore, we recommend that vitamin C and D should be routinely measured in clinical practice.
维生素 C 和 D 缺乏在临床实践中都极为常见，尤其是在老年人群中。不幸的是，维生素 C 缺乏在骨质疏松相关后果中的作用往往被忽视。本研究旨在分析维生素 C 和 D 联合缺乏是否与骨密度（BMD）和骨质疏松性椎体骨折（OVF）有关。
中山大学附属第三医院脊柱外科收治的 99 例绝经后女性患者纳入本研究。将参与者分为四组：维生素 D 缺乏组（对照组）、维生素 C 缺乏组和维生素 C 和 D 联合缺乏组（实验组）。分析维生素 C、维生素 D、钙、磷、BMD 和 OVF 情况。
维生素 C 和 D 水平在各组间存在统计学差异。在腰椎 BMD 方面，维生素 D 缺乏组与维生素 C 和 D 联合缺乏组之间存在显著差异。只有维生素 C 和 D 联合缺乏与腰椎 BMD 和 T 评分呈显著负相关。同样，维生素 C 和 D 联合缺乏与腰椎骨质疏松症呈显著正相关。各组与 OVF 均无显著相关性。维生素 C 和 D 联合缺乏与较低的腰椎 BMD 和骨质疏松症显著相关。
维生素 C 和 D 联合缺乏导致骨矿物质密度降低和骨质疏松症风险增加。我们认为这两种维生素的缺乏可能存在协同作用。因此，我们建议在临床实践中常规测量维生素 C 和 D。
