Background In Spanish population, there is a high prevalence of hypovitaminosis D which is more severe in elderly patients and, above all, in patients with hip fracture.
Objectives Study the analytical parameters of phospho-calcium metabolism in patients with hip fracture, with special emphasis on the serum concentration of calcidiol and on response to supplements of calcium and vitamin D.
Methods Prospective cross-sectional study including individuals admitted for hip fracture to a university hospital in the period between March 1, 2009 and December 31, 2010. Pathological or secondary to high impact trauma fractures, and patients with a glomerular filtrate <30 ml/min were excluded (n: 101).All patients were interviewed and variables were systematically introduced into a database. Socio-demographic, clinical and analytical data related to the status of the patient prior to fracture, complications arising during admission and follow-up were collected at 3 months and a year. The following analytical parameters of phospho-calcium metabolism were identified in peripheral blood: corrected calcium, phosphate, total alkaline phosphatase (FFAA), calcidiol, and parathormone (PTH). Seventy-eight (24%) patients were receiving supplements of calcium and vitamin D. Deficiency of vitamin D was defined as the serum concentration of calcidiol <25 nM/L andinsufficiencyas <50 nM/L.
Results We included 324 patients (83±8 years, 71% women). The analytical parameters are shown in the table below.
58% of patients had vitamin D deficiency. The monthly distribution of the average concentrations of calcidiol showed a statistically significant increase in the summer months. Patients receiving calcium and vitamin D supplements had a higher mean serum concentration of calcidiol (47.6±43.4 nM/L vs 25.2±11.2 nM/L; p<0.001), a lower vitamin D deficiency (24% vs. 60%; p<0.001) and insufficiency (71% vs 96%; p<0.001) than those who did not receive them. The rest of analytical parameters were not different between the two groups.
Conclusions In hospitalized patients with hip fracture, there is a high prevalence of hypovitaminosis D which did not achieve a satisfactory decrease in the subgroup that received vitamin D supplements.
Disclosure of Interest None Declared
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