Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 2;19(1):460.
doi: 10.1186/s13018-024-04953-z.

The association of combined vitamin C and D deficiency with bone mineral density and vertebral fracture

Lei He #  1   2   3 , Kishor Chhantyal #  4 , Zihao Chen #  1   2   3 , Ruijue Zhu  1   2   3 , Liangming Zhang  5   6   7
Affiliations

The association of combined vitamin C and D deficiency with bone mineral density and vertebral fracture

Lei He et al. J Orthop Surg Res. .

Abstract

Purpose: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Bone mineral density; Osteoporosis; Vertebral fractures; Vitamin C; Vitamin D.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The mean plots of T score, including lumbar (A), femur neck (B), total hip (C); and the mean plots of BMD, including lumbar (D), femur neck (E), and total hip (F)
Fig. 2
Fig. 2
The incidences of OVF and osteoporosis among vitamin C deficiency, vitamin D deficiency, and combined vitamin C and D deficiency groups
See this image and copyright information in PMC

References

    1. Allison RJ, Farooq A, Cherif A, Hamilton B, Close GL, Wilson MG. Why don’t serum vitamin D concentrations associate with BMD by DXA? A case of being ‘bound’ to the wrong assay? Implications for vitamin D screening. Br J Sports Med. 2018;52(8):522–6. 10.1136/bjsports-2016-097130 - DOI - PubMed
    1. Migliorini F, Giorgino R, Hildebrand F, Spiezia F, Peretti GM, Alessandri-Bonetti M et al. Fragility fractures: risk factors and management in the Elderly. Med (Kaunas Lithuania). 2021;57(10). - PMC - PubMed
    1. Migliorini F, Colarossi G, Eschweiler J, Oliva F, Driessen A, Maffulli N. Antiresorptive treatments for corticosteroid-induced osteoporosis: a bayesian network meta-analysis. Br Med Bull. 2022;143(1):46–56. 10.1093/bmb/ldac017 - DOI - PMC - PubMed
    1. Migliorini F, Colarossi G, Baroncini A, Eschweiler J, Tingart M, Maffulli N. Pharmacological management of postmenopausal osteoporosis: a Level I evidence based - Expert Opinion. Expert Rev Clin Pharmacol. 2021;14(1):105–19. 10.1080/17512433.2021.1851192 - DOI - PubMed
    1. Conti V, Russomanno G, Corbi G, Toro G, Simeon V, Filippelli W, et al. A polymorphism at the translation start site of the vitamin D receptor gene is associated with the response to anti-osteoporotic therapy in postmenopausal women from southern Italy. Int J Mol Sci. 2015;16(3):5452–66. 10.3390/ijms16035452 - DOI - PMC - PubMed

LinkOut - more resources