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Multicenter Study
. 2008 Aug 19;149(4):242-50.
doi: 10.7326/0003-4819-149-4-200808190-00005.

Serum 25-hydroxyvitamin D concentrations and risk for hip fractures

Jane A Cauley  1 , Andrea Z Lacroix, LieLing Wu, Mara Horwitz, Michelle E Danielson, Doug C Bauer, Jennifer S Lee, Rebecca D Jackson, John A Robbins, Chunyuan Wu, Frank Z Stanczyk, Meryl S LeBoff, Jean Wactawski-Wende, Gloria Sarto, Judith Ockene, Steven R Cummings
Affiliations
Multicenter Study

Serum 25-hydroxyvitamin D concentrations and risk for hip fractures

Jane A Cauley et al. Ann Intern Med. .

Abstract

Background: The relationship between serum 25-hydroxyvitamin D [25(OH) vitamin D] concentration and hip fractures is unclear.

Objective: To see whether low serum 25(OH) vitamin D concentrations are associated with hip fractures in community-dwelling women.

Design: Nested case-control study.

Setting: 40 clinical centers in the United States.

Participants: 400 case-patients with incident hip fracture and 400 control participants matched on the basis of age, race or ethnicity, and date of blood draw. Both groups were selected from 39 795 postmenopausal women who were not using estrogens or other bone-active therapies and who had not had a previous hip fracture.

Measurements: Serum 25(OH) vitamin D was measured and patients were followed for a median of 7.1 years (range, 0.7 to 9.3 years) to assess fractures.

Results: Mean serum 25(OH) vitamin D concentrations were lower in case-patients than in control participants (55.95 nmol/L [SD, 20.28] vs. 59.60 nmol/L [SD, 18.05]; P = 0.007), and lower serum 25(OH) vitamin D concentrations increased hip fracture risk (adjusted odds ratio for each 25-nmol/L decrease, 1.33 [95% CI, 1.06 to 1.68]). Women with the lowest 25(OH) vitamin D concentrations (< or =47.5 nmol/L) had a higher fracture risk than did those with the highest concentrations (> or =70.7 nmol/L) (adjusted odds ratio, 1.71 [CI, 1.05 to 2.79]), and the risk increased statistically significantly across quartiles of serum 25(OH) vitamin D concentration (P for trend = 0.016). This association was independent of number of falls, physical function, frailty, renal function, and sex-steroid hormone levels and seemed to be partially mediated by bone resorption.

Limitations: Few case-patients were nonwhite women. Bone mineral density and parathyroid hormone levels were not accounted for in the analysis.

Conclusion: Low serum 25(OH) vitamin D concentrations are associated with a higher risk for hip fracture.

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References

    1. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477–501. - PubMed
    1. Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 2002;30(5):771–7. - PubMed
    1. Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J Med. 1998;338(12):777–83. - PubMed
    1. LeBoff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J. Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA. 1999;281(16):1505–11. - PubMed
    1. Cranney A, Horsley T, O'Donnell T, et al. Evidence Report/Technical Assessment No. 158 (Prepared by the Univerisity of Ottawa Evidence-based Practice Center (UOEPC) under Contract No 290−02−0021. Agency for Healthcare Research and Quality. .; Rockville, MD: 2007. Effectiveness and safety of Vitamin D in relation to bone health. AHRQ Publication No. 07-E013.

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