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09-12-2009 | Bone health | Article

Vitamin D insufficiency contributes to vertebral fracture risk

Abstract

Free abstract

Medwire news: Vitamin D insufficiency is a contributing factor for moderate-to-severe vertebral fractures in elderly women, report Brazilian researchers.

The findings, published in the journal Maturitas, emphasize the importance of including this modifiable risk factor when evaluating elderly women, say Rosa Pereira (Universidade de São Paulo) and co-workers.

Previous studies have shown that a high proportion of hip fracture patients have vitamin D insufficiency and other studies have shown that calcium and vitamin D supplementation prevent hip fractures in elderly women, especially those with pre-established low levels.

However, a correlation between vertebral fractures and vitamin D status has not been established.

Pereira and team analyzed more than 415 elderly women over 2 years in São Paulo, Brazil, of whom 226 had no fractures and 189 had at least one moderate/severe vertebral fracture. Bone mineral density (BMD), serum vitamin D, and calcium levels were among the factors studied.

Patients in the no fracture group had lower age, increased height, higher calcium intake, and higher BMD compared with those in the fracture group. Serum levels of vitamin D in the no fracture group were higher than those in the fracture group (51.73 nmol/l vs 42.31 nmol/l). Reinforcing this finding, vitamin D insufficiency (<75 nmol/l) was less prevalent in the no fracture group than the fracture group (82.3% vs. 93.7%).

After adjustment for variables within the patient population, the analysis showed that age (OR=1.09) femoral neck BMD (OR=0.70) and vitamin D lower than 75 nmol/l (OR=2.38) significantly predicted vertebral fracture.

“It is important to emphasize that prevalent vertebral fractures are associated with an increase in morbidity and mortality. Moreover, post-menopausal women with severe vertebral fracture are at the highest risk of subsequent vertebral and nonvertebral fracture,” say Pereira and co-workers.

“The finding that low (<75 nmol/l) vitamin D concentrations are correlated with moderate/severe vertebral fractures supports the inclusion of this modifiable risk factor as part of the screening, and the identification of elderly community-dwelling women with a high risk of vertebral fracture,” they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Tony Kirby

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