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Kanno A, Aizawa T, Mori Y, Aizawa T. Different types of hip fragility fractures have different values of 25-hydroxyvitamin D and parathyroid hormone. J Orthop Sci 2024; 29:256-261. [PMID: 36435724 DOI: 10.1016/j.jos.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vitamin D insufficiency/deficiency is related to fragility fracture. In most previous studies, there was no assessment of vitamin D deficiency status separately for hip fracture types. The first aim is to evaluate vitamin D and parathyroid hormone (PTH) status in patients with hip fracture. The second objective is to determine whether there are differences in vitamin D and PTH between the femoral neck fracture and the femoral metaphyseal fracture group. METHODS 62 men and 248 women with fragility hip fractures were enrolled. 25-hydroxyviamin D [25(OH)D] and intact PTH (iPTH) values were evaluated, and femoral neck bone mineral density (BMD) was measured on the uninjured side. Vertebral fractures (VFs) were assessed using radiographs of the thoracic and lumbar spine. We examined the relationships of 25(OH)D value with the number of prevalent VFs, T-score of femoral neck, and iPTH level. These analyses were also performed, neck fracture and trochanteric fracture separately. RESULTS Mean age was 85 years. The mean 25(OH)D was 11.2 (range, 4.0-26.1) ng/ml, whereas the mean iPTH value was 48.9 pg/ml (range, 9-429 pg/ml). The mean number of VFs was 1.5 (range, 0-11), and the mean T-score was -3.3 (range, -5.2 to -0.5). There was a weak correlation between the 25(OH)D value and the number of VFs. There was a weak but significant correlation between 25(OH)D and iPTH values. In the patients with trochanteric fractures, 25(OH)D value was significantly lower and iPTH value was significantly higher than those with neck fractures. There was a significant correlation between the 25(OH)D value and number of the VFs, 25(OH)D, and iPTH values only in trochanteric fractures. CONCLUSIONS Vitamin D deficiency was severe and PTH levels were higher in the trochanteric fractures. Both vitamin D deficiency and high PTH levels were suggested to have association with bone fragility.
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Affiliation(s)
- Atsuko Kanno
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Sendai South Hospital, Japan; Department of Orthopaedic Surgery, Iwaki City Medical Center, Japan.
| | - Toshitake Aizawa
- Department of Orthopaedic Surgery, Iwaki City Medical Center, Japan
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Japan
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2
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Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R, Lavorgna M, Colao A, Di Somma C. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne) 2023; 14:1231580. [PMID: 37693364 PMCID: PMC10484397 DOI: 10.3389/fendo.2023.1231580] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body's capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.
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Affiliation(s)
- Fiammetta Romano
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Serpico
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Antonella Di Sarno
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Carmine Dalia
- Internal Medicine S. Maria Della Pietà Hospital Nola, Nola, Italy
| | - Rossana Arianna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Colao
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
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Chiang MH, Kuo YJ, Chang WC, Wu Y, Lin YC, Jang YC, Chen YP. Association of Vitamin D Deficiency with Low Serum Albumin in Taiwanese Older Adults with Hip Fracture: A Prospective Cross-Sectional Study. J Nutr Sci Vitaminol (Tokyo) 2021; 67:153-162. [PMID: 34193674 DOI: 10.3177/jnsv.67.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The world's population is aging, and the prevalence of hip fracture is rising. Vitamin D deficiency is a risk factor for hip fracture and predicts functional recovery and survival following hip fracture surgery. This cross-sectional study identified the prevalence of vitamin D deficiency in Taiwanese older patients with hip fracture and potential risk factors for vitamin D deficiency. Data from older adults with hip fracture admitted to a single medical center in Taipei, Taiwan were prospectively collected. The preoperative serum 25-hydroxyvitamin D [25(OH)D] concentration and comprehensive clinical history of each patient were examined. A multinomial logistic regression model was used to compare the clinical characteristics of deficient, insufficient, and sufficient 25(OH)D concentration groups. The cohort comprised 310 older adults with hip fracture. The mean age was 80±10 y. The deficient, insufficient, and sufficient groups comprised 180, 84, and 46 patients (58.1%, 27.1%, and 14.8%), respectively. Univariate analysis revealed significant intergroup differences in serum albumin level and body fat percentage and marginally significant differences in serum albumin, estimated glomerular filtration rate, body mass index, and comorbidities of affective or psychotic disorders. In the multinomial logistic regression model, albumin level was the only factor significantly correlated with higher 25(OH)D concentrations in the sufficient and insufficient groups compared with the deficient group. No variable, including preinjury functional status, was significantly correlated with vitamin D deficiency except malnutrition. Our findings may aid the establishment of a robust screening and treatment program for vitamin D deficiency.
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Affiliation(s)
- Ming-Hsiu Chiang
- Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital
| | - Yi-Jie Kuo
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University.,Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University
| | - Wei-Chun Chang
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University
| | - Yueh Wu
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University
| | - Ying-Chin Lin
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University.,Department of Family Medicine, Wan Fang Hospital, Taipei Medical University.,Department of Geriatric Medicine, School of Medicine, College of Medicine, Taipei Medical University
| | - Yeu-Chai Jang
- Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University.,Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University
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Kandemiş E, Tuncel G, Fahrioğlu U, Temel ŞG, Mocan G, Ergören MÇ. Natural selection at work? Vitamin D deficiency rates and rising health problems in young Turkish Cypriot professionals. Cent Eur J Public Health 2021; 29:130-133. [PMID: 34245553 DOI: 10.21101/cejph.a6117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Vitamin D is a fat-soluble, prohormone vitamin that is important especially for bone mineralization and skeletal health. In recent years, vitamin D deficiency appeared as a worldwide problem, affecting many people in different ways including the Northern Cypriot population. The deficiency might be caused by the lack of exposure to sunlight, diet low in vitamin D, sedentary lifestyle, and also due to some genetic variations in the vitamin D receptor (VDR) gene. METHODS In this study, four common VDR polymorphisms and associations with vitamin D deficiency in the Turkish Cypriot population between ages 18-40 and working in office conditions was studied by PCR- RFLP analysis. RESULTS rs2228570 C>T variant was shown to be significantly associated with low serum vitamin D levels in the studied population. CONCLUSION Together with the effect of rs2228570 C>T variant in the VDR gene, it is thought that the lifestyle changes in the Turkish Cypriot population might have caused the increased frequency of vitamin D deficiency in the young professionals.
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Affiliation(s)
- Emine Kandemiş
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Bahcesehir University, Istanbul, Turkey
| | - Gülten Tuncel
- DESAM Institute, Near East University, Nicosia, Cyprus
| | - Umut Fahrioğlu
- DESAM Institute, Near East University, Nicosia, Cyprus.,Department of Medical Biology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Şehime Gülsün Temel
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Gamze Mocan
- Department of Medical Biology, Faculty of Medicine, Near East University, Nicosia, Cyprus.,Department of Medical Pathology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Mahmut Çerkez Ergören
- DESAM Institute, Near East University, Nicosia, Cyprus.,Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
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Yu SJ, Yang Y, Zang JC, Li C, Wang YM, Wang JB. Evaluation of Serum 25-Hydroxyvitamin D 3 and Bone Mineral Density in 268 Patients with Hip Fractures. Orthop Surg 2021; 13:892-899. [PMID: 33783959 PMCID: PMC8126932 DOI: 10.1111/os.12920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 10/31/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022] Open
Abstract
Objective The aim of the present study was to evaluate the relationship among vitamin D nutritional status, bone mineral density, and other factors in elderly patients with brittle hip fractures. Methods The present study was a retrospective analysis of 268 patients, 102 men (38.06%) and 166 women (61.94%), with brittle hip fractures admitted to the Hip Joint Center of Tianjin Hospital from February 2016 to June 2018. The median age of the patients was 74 years (range, 50–93 years). The patients were divided into three groups based on age: ≤69 years, 70–79 years, and ≥80 years. Serum 25‐hydroxyvitamin D3 (25(OH) D3), parathyroid hormone (PTH), body mass index (BMI), and bone mineral density (BMD) of the lumbar spine, femoral neck, and hip were measured and statistically analyzed. Results The median serum 25(OH)D3 level of patients was 9.90 (range, 2.60–42.70) ng/mL; the proportion of deficiency was 89.18% and the deficiency was severe in 136 cases (49.25%). The proportion of vitamin D deficiency was significantly lower in men than in women (P = 0.013). With the increase of age, 25(OH)D3 levels gradually decreased (P = 0.044) and PTH levels gradually increased (P < 0.001). There was significantly negative correlation (P < 0.001) between the levels of serum 25(OH)D3 and PTH. There were 200 cases (74.63%) in which T‐values of BMD were less than −2.5 in any part of the lumbar vertebrae, femoral neck, and hip. T‐values in 74 cases (27.61%) were less than −2.5 in all three parts. The T‐values of BMD in men were significantly higher than those in men (P < 0.001). With the increase of age, the femoral neck BMD in men gradually decreased (P = 0.016), and the femoral neck and hip BMD in female gradually decreased (P‐value was 0.001 and 0.003, respectively). Multivariate analysis suggested that gender and BMI were independent risk factors for BMD, and vitamin D deficiency affected BMD. Conclusion Vitamin D deficiency is common in patients with brittle hip fractures, especially in women. With the increase of age, vitamin D continues to decrease and PTH increases. The decrease of BMD in patients with hip fractures is the result of a combination of age, gender, BMI, and vitamin D content.
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Affiliation(s)
- Shu-Jun Yu
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Yang Yang
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Jia-Cheng Zang
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Chen Li
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Yu-Min Wang
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Jing-Bo Wang
- Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
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Effects of ultraviolet irradiation with a LED device on bone metabolism associated with vitamin D deficiency in senescence-accelerated mouse P6. Heliyon 2020; 6:e03499. [PMID: 32140604 PMCID: PMC7052073 DOI: 10.1016/j.heliyon.2020.e03499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/13/2019] [Accepted: 02/24/2020] [Indexed: 12/31/2022] Open
Abstract
Aims This study investigated effects of narrow-range ultraviolet irradiation (UVR) by a new UV–LED device on vitamin D supply and changes of bone in senescence-accelerated mouse P6 (SAMP6) with vitamin D deficiency. Main methods We used female SAMP6 mice as a senile osteoporotic model. We set a total of 3 groups (n = 4 per group); D-UVR+ group (vitamin D deficient–dietary and UVR), D- (vitamin D deficient–dietary), and D+ groups (vitamin D contained–dietary). Mice in the D-UVR + group were UV–irradiated (305nm) with 1 kJ/m2 twice a week for 12 weeks from 20 to 32 weeks of age. Serum 25(OH)D, 1,25(OH)2D, and micro–computed tomography (CT) were assessed over time. Mechanical test, and histological assay were performed for femurs removed at 32 weeks of age. Key findings UVR increased both serum 25(OH)D and 1,25(OH)2D levels at 4 and 8 weeks–UVR in the D-UVR+ group compared with that in the D- group (P < 0.05, respectively). Relative levels of trabecular bone mineral density in micro–CT were higher in the D-UVR+ group than in the D- group at 8 weeks–UVR (P = 0.048). The ultimate load was significantly higher in the D-UVR+ group than in the D- group (P = 0.036). In histological assay, fewer osteoclasts and less immature bone (/mature bone) could be observed in the D-UVR+ group than in the D- group, significantly. Significance UVR may have possibility to improve bone metabolism associated with vitamin D deficiency in SAMP6 mice.
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Dretakis K, Igoumenou VG. The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type. Aging Clin Exp Res 2019; 31:1501-1507. [PMID: 30701437 DOI: 10.1007/s40520-019-01132-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Fragility fractures of the hip are associated with high morbidity and mortality, and represent a rather devastating consequence of osteoporosis. Hip fractures are traditionally investigated as a whole, although it has been recently implied that distinct pathogenic mechanisms may lead either to trochanteric or subcapital fractures. AIMS To investigate whether differences exist by hip fracture type with respect to serum 25(OH)D (vitamin D) and parathyroid hormone (PTH) levels, in addition to epidemiological and demographic data, including history of falls. METHODS The inclusion criteria were met by 116 patients [48 men and 68 women; mean age 80.8 ± 8.5 (range 62-94) years]. Patients were analyzed according to hip fracture type, history of falls, and vitamin D and PTH status. RESULTS Older age, recurrent falls, serum levels of PTH > 65 pg/ml, and severe vitamin D deficiency were found to be associated with trochanteric fractures. Additionally, older age, female gender, PTH > 65 pg/ml, and severe vitamin D deficiency were related to recurrent falls. Meanwhile, patients with absence of PTH response to low vitamin D levels, were not repeated fallers and suffered mostly from subcapital fractures. DISCUSSION AND CONCLUSION Elevated PTH levels predispose both to falls and trochanteric fractures, while vitamin D-deficient patients with normal PTH levels are mostly related to subcapital fractures. It is thereby indicated that different pathophysiological processes lie behind subcapital and trochanteric fractures. A better understanding of these mechanisms may assist in the development of prevention strategies for individuals recognized at risk for falls and either type of hip fracture.
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Affiliation(s)
| | - Vasilios G Igoumenou
- First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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