Occult vitamin D deficiency in postmenopausal US women with acute hip fracture
Occult vitamin D deficiency in postmenopausal US women with acute hip fracture
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DOI：
10.1001/jama.281.16.1505
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发表时间：
1999-04-28
影响因子：
120.7
通讯作者：
Glowacki, J
中科院分区：
文献类型：
--
作者：
LeBoff, MS;Kohlmeier, L;Glowacki, J
低维生素D水平可能导致女性髋部骨折，尽管关于美国入院的急性髋部骨折女性的维生素D水平的数据有限。目的探讨绝经后髋部骨折患者与接受择期关节置换术的非骨质疏松和骨质疏松患者相比，是否存在维生素D水平低和甲状旁腺激素水平高的情况。设计：比较1995年1月至1998年6月期间进行的病例系列研究，背景和患者：98名无继发性骨质流失的绝经后社区妇女接受髋关节置换术，其中30名妇女患有急性髋部骨折，68名妇女接受选择性关节置换术。在接受选择性关节置换术的妇女中，17人患有骨质疏松症，51人没有骨质疏松症。有合并症或正在服用影响骨密度和骨循环的药物的妇女被排除在外。主要观察指标主要观察指标为维生素D和甲状旁腺激素水平；次要指标是身体成分和骨转换标志物。结果髋部骨折患者25-羟基维生素D水平低于非骨质疏松患者择期关节置换术（P= 0.02）和骨质疏松患者择期关节置换术（P= 0.01）（中位数分别为32.4、49.9和55.0 nmol/L；比较调整了年龄和雌激素摄入量）。骨折妇女的甲状旁腺激素水平高于非骨质疏松对照组(P
Context Low vitamin D levels may contribute to hip fractures in women, although limited data are available on vitamin D levels in US women admitted with acute hip fractures.Objective To determine whether postmenopausal women with hip fractures have low vitamin D and high parathyroid hormone levels compared with nonosteoporotic and osteoporotic women admitted for elective joint replacement.Design Comparative case series conducted between January 1995 and June 1998,Setting and Patients Ninety-eight postmenopausal community-dwelling women with no secondary causes of bone loss admitted for hip replacement, of whom 30 women had acute hip fractures and 68 women were admitted for elective joint replacement. Of the women admitted for elective joint replacement, 17 had osteoporosis and 51 did not. Women with comorbid conditions or who were taking medications that affect bone density and turnover were excluded.Main Outcome Measures Primary measures were levels of vitamin D and parathyroid hormone; secondary measures were body composition and markers of bone turnover.Results Women with hip fractures had lower levels of 25-hydroxyvitamin D than women without osteoporosis admitted for elective joint replacement (P=.02) and than women with osteoporosis admitted for elective joint replacement (P=.01) (medians, 32.4, 49.9, and 55.0 nmol/L, respectively; comparisons adjusted for age and estrogen intake). Parathyroid hormone levels were higher in women with fractures than women in the nonosteoporotic control group (P