Faculty of Medicine, University of Novi Sad, 21137 Novi Sad, Serbia.
Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Vojvodina, 21137 Novi Sad, Serbia.
Nutrients. 2024 Aug 14;16(16):2702. doi: 10.3390/nu16162702.
Bone fractures are a significant public health issue among elderly subjects. This study examines the impact of diet and vitamin D status on the risk of long bone fractures due to falls in elderly subjects in Vojvodina, Serbia. Conducted at the University Clinical Center of Vojvodina in autumn/winter 2022-2023, the study included 210 subjects >65 years: 105 (F: 80/M: 15) with long bone fractures due to falls and 105 (F: 80/M: 15) controls. Groups were similar regarding age and BMI. Dietary intakes (by two 24-h recalls) and serum vitamin D levels were analyzed. The fracture group had a significantly lower median daily vitamin D intake (1.4 μg/day vs. 5.8 μg/day), intake of calcium, energy, proteins, fats, fibers, dairy products, eggs, fish, edible fats/oils, and a higher intake of sweets ( < 0.001 for all). Serum vitamin D levels were significantly lower in the fracture group (40.0 nmol/L vs. 76.0 nmol/L, < 0.001). Logistic regression identified serum vitamin D as the most important protective factor against fractures, and ROC curve analysis indicated that serum vitamin D levels > 50.5 nmol/L decreased fracture risk. Nutritional improvements (increased intake of vitamin D and protein sources such as fish, eggs, and dairy), increased sun exposure, and routine vitamin D supplementation during winter are advised.
骨骨折是老年人中一个重大的公共卫生问题。本研究探讨了饮食和维生素 D 状况对塞尔维亚伏伊伏丁那省老年人因跌倒导致长骨骨折风险的影响。该研究于 2022-2023 年秋冬在伏伊伏丁那大学临床中心进行，纳入了 210 名年龄>65 岁的受试者：105 名（女性 80 名，男性 15 名）因跌倒导致长骨骨折，105 名（女性 80 名，男性 15 名）为对照组。两组在年龄和 BMI 方面相似。分析了膳食摄入量（通过两次 24 小时回忆）和血清维生素 D 水平。骨折组的每日维生素 D 摄入量中位数明显较低（1.4μg/天对 5.8μg/天），钙、能量、蛋白质、脂肪、纤维、乳制品、鸡蛋、鱼类、食用脂肪/油和甜食的摄入量较高（所有均<0.001）。骨折组的血清维生素 D 水平明显较低（40.0nmol/L 对 76.0nmol/L，<0.001）。Logistic 回归确定血清维生素 D 是预防骨折最重要的保护因素，ROC 曲线分析表明血清维生素 D 水平>50.5nmol/L 可降低骨折风险。建议改善营养（增加维生素 D 和鱼类、鸡蛋、乳制品等蛋白质来源的摄入）、增加阳光暴露以及在冬季常规补充维生素 D。
