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Vitamin D and intact PTH status in patients with hip fracture

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Abstract

Introduction

The prevalence of hypovitaminosis D in patients with acute hip fracture was examined in a population on Sado Island in Japan. There were 85 cases of hip fracture among this population in 2004, giving an overall incidence of hip fracture of 121.4 per 100,000 population per year. This study included 50 of the 85 cases, and these cases were defined as the hip fracture group. Patients older than 70 years without established osteoporosis who were admitted to the hospital on the island during almost the same period for treatment of an orthopedic condition other than a hip fracture were defined as the control group.

Materials and methods

The levels of serum 25-hydroxyvitamin D (25-OHD), intact parathyroid hormone (intact PTH), alkaline phosphatase (ALP), albumin, and the number of remaining teeth were examined in each group. In the hip fracture group, serum calcium, serum phosphorus, urine N-terminal cross-linking telopeptide of type I collagen (NTx), bone mineral density (BMD) of the nonfractured hip, the presence of a vertebral fracture on X-ray, severity of dementia, and physical activity level were also examined.

Results

Both the serum 25-OHD and serum albumin levels were significantly lower in patients with hip fracture than in controls, and the intact PTH level was significantly higher in patients with hip fracture. The number of remaining teeth was correlated with age, and was also significantly correlated with 25-OHD. In the hip fracture group, 62% of the subjects had hypovitaminosis D (25-OHD <20 ng/ml) and one-fifth of cases with hypovitaminosis D showed elevated PTH levels (>65 pg/ml). On the other hand, in the control group, hypovitaminosis D occurred in 18.9% of the subjects, and only one case showed elevated PTH. The serum 25-OHD level showed a decrease as the severity of dementia progressed and the activity level decreased.

Conclusion

Our results indicate that about two-thirds (62%) of hip fracture patients had vitamin D insufficiency, suggesting that this condition may be closely associated with hip fracture in elderly people. Therefore, the serum 25-OHD level may be a useful index for the risk of hip fracture in elderly people.

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References

  1. Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD (1996) Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 11(3):337–349

    Article  PubMed  CAS  Google Scholar 

  2. Cumming RG, Klineberg RJ (1994) Case-control study of risk factors for hip fractures in the elderly. Am J Epidemiol 139:493–503

    PubMed  CAS  Google Scholar 

  3. Nuti R, Martini G, Valenti R, Gambera D, Gennari L, Salvadori S, Avanzati A (2004) Vitamin D status and bone turnover in women with acute hip fracture. Clin Orthop Relat Res 422:208–213. DOI 10.1097/01.blo.0000129163.97988.06

    Article  PubMed  Google Scholar 

  4. LeBoff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281(16):1505–1511

    Article  PubMed  CAS  Google Scholar 

  5. Payne RB, Little AJ, Williams RB, Milner JR (1973) Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J 4:643–646

    Article  PubMed  CAS  Google Scholar 

  6. Omote M, Nakagawa K, Matsushima H, Yasui T (1997) Evaluation of chemiluminescence immunoassay kit “Lumico PTH” and “Lumico ACTH”. Jpn J Med Pharm Sci 38(4):805–812

    CAS  Google Scholar 

  7. Paudian MR, Segre GV, Sherrard D, Potts JT, Lavigne JR, Carlton EI (1983) Immunoradiometric assay for intact PTH: a new generation of PTH assay for assessment of parathyroid function. Nichols Institute Reference Laboratories 60-712-204:1–7

  8. Segersten U, Correa P, Hewison M, Hellman P, Dralle H, Carling T, Akerstrom G, Westin G (2002) 25-hydroxyvitamin D(3)-1alpha-hydroxylase expression in normal and pathological parathyroid glands. J Clin Endocrinol Metab 87(6):2967–2972

    Article  PubMed  CAS  Google Scholar 

  9. Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135:317–322

    PubMed  CAS  Google Scholar 

  10. Malabanan A, Veronikis E, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  PubMed  CAS  Google Scholar 

  11. Need AG, Horowitz M, Morris HA, Nordin BC (2000) Vitamin D status: effects on parathyroid hormone and 1,25-dihydroxyvitamin D in postmenopausal women. Am J Clin Nutr 71:1577–1581

    PubMed  CAS  Google Scholar 

  12. Sato S, Demura S, Minami M, Kasuga K (2002) Longitudinal assessment of ADL ability of partially dependent elderly people: examining the utility of the index and characteristics of longitudinal change in ADL ability. J Physiol Anthropol Appl Human Sci 21(4):179–187

    Article  PubMed  Google Scholar 

  13. Arai Y, Zarit SH, Kumamoto K, Takeda A (2003) Are there inequities in the assessment of dementia under Japan’s LTC insurance system? Int J Geriatr Psychiatry 18(4):346–352

    Article  PubMed  CAS  Google Scholar 

  14. Kanis JA, WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 4:368–381

    Article  PubMed  CAS  Google Scholar 

  15. Thiebaud D, Burckhardt P, Costanza M, Sloutskis D, Gilliard D, Quinodoz F, Jacquet AF, Burnand B (1997) Importance of albumin, 25(OH)-vitamin D and IGFBP-3 as risk factors in elderly women and men with hip fracture. Osteoporos Int 7:457–462. DOI 10.1007/s001980050033

    Article  PubMed  CAS  Google Scholar 

  16. Bollen AM, Taguchi A, Hujoel PP, Hollender LG (2004) Number of teeth and residual alveolar ridge height in subjects with a history of self-reported osteoporotic fractures. Osteoporos Int 15(12):970–974. DOI 10.1007/s00198-004-1695-1

    Article  PubMed  Google Scholar 

  17. Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B (2001) Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med 11(6):452–456

    Article  Google Scholar 

  18. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7(5):439–443. DOI 10.1007/s001980050030

    Article  PubMed  CAS  Google Scholar 

  19. Sahota O, Gaynor K, Harwood RH, Hosking D (2001) Hypovitaminosis D and ‘functional hypoparathyroidism’—the NoNoF (Nottingham Neck of Femur) study. Age Ageing 30:467–472

    Article  PubMed  CAS  Google Scholar 

  20. Sato Y, Asoh T, Oizumi K (1998) High prevalence of vitamin D deficiency and reduced bone mass in elderly women with Alzheimer’s disease. Bone 23(6):555–557

    Article  PubMed  CAS  Google Scholar 

  21. Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr 80:752–758

    PubMed  CAS  Google Scholar 

  22. Di Monaco M, Vallero F, Monaco R, Manutino F, Cavanna A (2005) Serum levels of 25-hydroxyvitamin D and functional recovery after hip fracture. Arch Phys Med Rehabil 86:64–68

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was performed with the permission of the Ethical Review Board of Sado General Hospital. The authors gratefully acknowledge all the staff at Sado General Hospital for their support in the collection of patient data. We acknowledge Teijin Pharma Limited and SRL Inc. for measurements of laboratory data.

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Authors and Affiliations

  1. Division of Rehabilitation Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi dori, Niigata, 951-8510, Japan

    M. Sakuma & N. Endo

  2. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    N. Endo, T. Hayami & S. Watanabe

  3. Department of Orthopedic Surgery, Sado General Hospital, Sado, Japan

    T. Oinuma, E. Endo, T. Yazawa & K. Watanabe

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  1. M. Sakuma
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  2. N. Endo
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  3. T. Oinuma
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  4. T. Hayami
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  5. E. Endo
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  6. T. Yazawa
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  7. K. Watanabe
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  8. S. Watanabe
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Correspondence to M. Sakuma.

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Sakuma, M., Endo, N., Oinuma, T. et al. Vitamin D and intact PTH status in patients with hip fracture. Osteoporos Int 17, 1608–1614 (2006). https://doi.org/10.1007/s00198-006-0167-1

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  • DOI: https://doi.org/10.1007/s00198-006-0167-1

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