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Influence of age and body mass on the effects of vitamin d on hip fracture risk

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Abstract

The role of vitamin D in the prevention of hip fracture is controversial and protective effects appear to be confined to the institutionalized and elderly population. The aim of this study was to assess the interaction of age and body mass index (BMI) on the effects of vitamin D on the risk of hip fracture in the community. We studied 1634 women with low-energy fractures of the hip aged 50 years or older, and 3532 age-matched controls from 14 centres in six Mediterranean countries (the MEDOS study), with a structured retrospective questionnaire. The use of vitamin D supplements was associated with a modest and non-significant decrease in the risk of hip fracture (RR=0.74; 95% confidence interval (CI) 0.53–1.03;p=0.07). The risk reduction was influenced by age and body mass. Women aged above 80 years had a significant decrease in the relative risk of hip fracture (RR=0.63; 95% CI 0.40–0.98) as did women with a BMI below 20 kg/m2 (RR=0.45; 95% CI 0.24–0.84). Elderly women were more likely to have a low BMI but the elderly did not appear to benefit from vitamin D where their BMI was 20 kg/m2 or higher. The findings could not be explained by differences in sun exposure or in physical exercise. We conclude that the use of vitamin D for the prevention of hip fracture might usefully be targeted to the frail and elderly.

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References

  1. Lips P, Netelenbos JC, Jongen MJM, et al. Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Rel Res 1982;4:85–93.

    Google Scholar 

  2. Chapuy MC, Arlot MC, Duboeuf F, Brun J, Crouzet B, Arnaud S, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.

    Google Scholar 

  3. Khaw K-T, Sneyd M-J, Compston J. Bone density, parathyroid hormone and 25-hydroxyvitamin D concentrations in middle aged women. BMJ 1992;305:273–7.

    Google Scholar 

  4. Aloia JF, Vaswani A, Yeh J, Ellis K, Yasamura S, Cohn SH. Calcitriol in the treatment of postmenopausal osteoporosis. Am J Med 1988;84:401–8.

    Google Scholar 

  5. Gallagher JC. Prevention of bone loss in postmenopausal and senile osteoporosis with vitamin D analogues. Osteoporosis Int 1993;Suppl 1:S172–5.

    Google Scholar 

  6. Gallagher JC, Goldgar D. Treatment of postmenopausal osteoporosis with high doses of synthetic calcitriol. Ann Intern Med 1990;113:649–55.

    Google Scholar 

  7. Jensen GF, Christiansen C, Transbol I. Treatment of postmenopausal osteoporosis: a controlled therapeutic trial comparing oestrogen/gestagen, 1,25-dihydroxy-vitamin D3 and calcium. Clin Endocrinol 1982;16:515–24.

    Google Scholar 

  8. Ott SM, Chestnut CH. Calcitriol treatment is not effective in postmenopausal osteoporosis. Ann Intern Med 1989;110:267–74.

    Google Scholar 

  9. Orimo H, Shiraki M, Hayashi T, Nakamura T. Reduced occurrence of vertebral crush fractures in senile osteoporosis treated with lαr(OH)-vitamin D3. Bone mineral 1987;3:47–52.

    Google Scholar 

  10. Heikinheimo RJ, Inkovaara JA, Haavisto MV, Harju EJ, Kaarala RH, Kataja JM, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 1992;51:105–10.

    Google Scholar 

  11. Miravet L, Chaumet-Riffaud P, Ranstam J. Residential care and risk of proximal femur fracture. Bone 1993;14:S73–5.

    Google Scholar 

  12. Kanis J, Johnell O, Gullberg B, Allander E, Dilsen G, Gennari C, et al. Evidence for efficacy of drugs affecting bone metabolism in preventing hip fracture. BMJ 1992;305:1124–8.

    Google Scholar 

  13. Kanis JA, Beneton MNC, Gennari C, Gullberg B, Johnell O, Mazzuoli GF, Passed M. Effects of anabolic steroids on cortical bone and fractures. In: Christiansen C, Riis B, editors. Osteoporosis 1993. Copenhagen: Osteopress, 1993:308–10.

    Google Scholar 

  14. Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM. Effect of vitamin D supplementation on the incidence of hip fractures in elderly people. J Bone Miner Res 1994;9:(Suppl 1):S148.

    Google Scholar 

  15. Elffors L, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, et al. The variable incidence of hip fracture in Southern Europe: the MEDOS study. Osteoporosis Int 1994;4:253–63.

    Google Scholar 

  16. Dequeker J, Ranstam J, Valsson J, Sigurgevisson B, Allander E. The Mediterranean Osteoporosis (MEDOS) Study questionnaire. Clin Rheumatol 1991;10:54–72.

    Google Scholar 

  17. Holick MF. Vitamin D and the skin: photobiology, physiology and therapeutic efficacy for psoriasis. Bone Miner Res Ann 1990;7:313–66.

    Google Scholar 

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Ranstam, J., Kanis, J.A. Influence of age and body mass on the effects of vitamin d on hip fracture risk. Osteoporosis Int 5, 450–454 (1995). https://doi.org/10.1007/BF01626607

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  • DOI: https://doi.org/10.1007/BF01626607

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