Is Vitamin D deficiency an endangerment for Fracture?

  • Dr. Ganesan Ram Associate Professor, Department of Orthopaedics, Velammal Medical College,Madurai, Tamil Nadu.India.
  • Dr. Ravi Raman Professor, Department of Orthopaedics, Velammal Medical College,Madurai, Tamil Nadu, India
Keywords: Vitamin D, Fracture, Fragility, Osteoporosis, DEXA

Abstract

Introduction: The incidence of fragility hip fracture is on a step increase. Vitamin D is essential for the growth and development of the bone. The decrease in the exposure to sun’s radiation leads to this deficiency causing a global threat. There were many studies pointing towards Vitamin D deficiency as a risk factor for fracture. However, the relationship between serum Vitamin D and bone mineral density (BMD) in the senile osteoporotic fracture is still unclear. The aim of this study is to find out whether Vitamin D deficiency is a risk factor for fragility fracture.

Method: It is a prospective study done at Sri Ramachandra Medical College Chennai and Velammal Medical college Madurai between Jan 2017 to Dec 2019. The inclusion criteria were male patients age more than seventy and female patients more than sixty presented with fragility hip fractures. The group I was the cases, patients with hip fractures. The group II was the age and gender-matched control. All the patients included in the study underwent both Vitamin D 25 OH and Dexa scan. The current study had 56 patients in group I as cases and 54 patients in group II as control.

Results: The mean value of vitamin D 25OH in fracture patient group I was 19.85 and the age and gender-matched control group was 26.09. The current study had totally seventy-nine patients in the study who were either Vitamin D deficient or insufficient. The present study had 16 cases patient and 15 controls who were having sufficient level vitamin D.

Conclusion: Vitamin D has no role in fracture prevention and certainly Vitamin D deficiency is not an endangerment for fractures.

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References

Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182(17):1864-1873. doi: https://doi.org/10.1503/cmaj.100771.

Tenenhouse A, Joseph L, Kreiger N, Poliquin S, Murray TM, Blondeau L, et al, CaMos Research Group. Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int. 2000;11(10):897-904. doi: https://doi.org/10.1007/s001980070050.

Ram GG, Govardhan P. In-Hospital Mortality following Proximal Femur Fractures in Elderly Population. Surg J. 2019;5(02):e53-e56. doi: https://doi.org/10.1055/s-0039-1692995.

Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84(1):18-28. doi: https://doi.org/10.1093/ajcn/84.1.18.

Ramason R, Selvaganapathi N, Ismail NH, Wong WC, Rajamoney GN, Chong MS. Prevalence of vitamin d deficiency in patients with hip fracture seen in an orthogeriatric service in sunny Singapore. Geriatr Orthop Surg Rehabil. 2014;5(2):82-86. doi: https://doi.org/10.1177/2151458514528952.

Solomon DH, Finkelstein JS, Katz JH, Mogun H, Avorn J. Underuse of osteoporosis medications in elderly patients with fractures. Am J Med. 2003;115(5):398-400. doi: https://doi.org/10.1016/s0002-9343(03)00357-7.

Behrouzi A, Hejazi H, Kamali A, Hadi H. Investigation of the outcome of patients with hip fractures using vitamin D3. Eur J Transl Myol. 2018;28(3):7372. doi: https://dx.doi.org/10.4081%2Fejtm.2018.7372.

Ganesan GR, Vijayaraghavan PV. Urinary N-telopeptide: The New Diagnostic Test for Osteoporosis. Surg J. 2019;5(1):e1-e4. doi: https://doi.org/10.1055/s-0038-1677483.

Ram GG, Jambu N. Urinary N-telopeptide-A diagnostic Test or A Screening Test? Int J Res Pharmaceut Sci. 2019;10(2):1298-1301. doi: https://doi.org/10.26452/ijrps.v10i2.424.

Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, et al. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity, and cancer: Recommendations for clinical practice. Autoimmunity Rev. 2010;9(11):709-715. doi: https://doi.org/10.1016/j.autrev.2010.06.009.

He W, Liu M, Huang X, Qing Z, Gao W. The influence of vitamin D receptor genetic variants on bone mineral density and osteoporosis in Chinese postmenopausal women. Disease markers. 2015;2015. doi: https://doi.org/10.1155/2015/760313.

Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. InMayo Clinic Proc 2013;8(7):720-755. doi: https://doi.org/10.1016/j.mayocp.2013.05.011.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clini Endocrinol Metabol. 2011;96(7):1911-1930. doi: https://doi.org/10.1210/jc.2011-0385.

Mosali P, Bernard L, Wajed J, Mohamed Z, Ewang M, Moore A, et al. Vitamin D status and parathyroid hormone concentrations influence the skeletal response to zoledronate and denosumab. Calcif Tissue Int. 2014;94(5):553-559. doi: https://doi.org/10.1007/s00223-014-9840-0.

Piscitelli P, Iolascon G, Gimigliano F, Muratore M, Camboa P, Borgia O, et al. Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey. Osteoporosis Int. 2007;18(2):211-219. doi: https://doi.org/10.1007/s00198-006-0224-9.

Wong YY, Flicker L. Hypovitaminosis D and frailty: Epiphenomenon or causal? Maturitas. 2015;82(4):328-335. doi: https://doi.org/10.1016/j.maturitas.2015.07.027.

Bolland MJ, Grey A, Avenell A. Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis. The Lancet Diabetes Endocrinol. 2018;6(11):847-858. doi: https://doi.org/10.1016/s2213-8587(18)30265-1.

Gallagher JC. Vitamin D and bone density, fractures, and falls: the end of the story? Lancet Diabetes Endocrinol. 2018;6(11):834-835. doi: https://doi.org/10.1016/s2213-8587(18)30269-9.

Published
2020-02-18
How to Cite
Dr. Ganesan Ram, & Dr. Ravi Raman. (2020). Is Vitamin D deficiency an endangerment for Fracture?. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 6(1), 35-39. https://doi.org/10.17511/ijoso.2020.i01.06
Section
Original Article