Different types of hip fragility fractures have different values of 25-hydroxyvitamin D and parathyroid hormone

Osteoporosis is a skeletal disorder of reduced bone strength that leads to fragility fracture [1]. These fractures, especially hip fractures diminish their quality of life and increases mortality [2].

Vitamin D deficiency is related to insufficient calcium absorption from the intestine and deficient bone mineralization. It is also associated with the subsequent development of osteoporosis [3]. Vitamin D deficiency also results in secondary hyperparathyroidism, which leads to excessive bone resorption and osteomalacia [3]. Because 25-hydroxyvitamin D [25(OH)D] is the primary form of vitamin D in the human body, its value is used to assess vitamin D status [3].

It was reported that vitamin D insufficiency and deficiency increased the risks of falls and fragility fractures [4,5]. Vitamin D insufficiency and deficiency are widely observed in community-dwelling healthy people in Japan and Singapore [6,7], although there were differences in the degree of decrease in 25(OH)D values by ethnicity. In vitro, it has been reported that vitamin D administration promotes myocyte differentiation [8]. Although there are reports of improved lower extremity muscle strength in osteoporosis patients treated with vitamin D, the effect of vitamin D administration in preventing falls is controversial [9]. However, there have been a few reports on vitamin D status in Japanese patients with hip fragility fractures [[10], [11]].

Hip fracture is classified into neck fracture and trochanteric fracture. In a previous report, the association between the 25(OH)D value and intact parathyroid hormone (iPTH) value is different between these fracture types [12]. However, most previous studies did not analyze these hip fracture types separately.

According to the criteria of the Japanese Osteoporosis Society, we diagnose patients with hip or vertebral fracture (VF) as osteoporosis if index fracture occurs after a fall from a standing position [13]. Approximately only one-fourth of postmenopausal women with radiographic VF are symptomatic [14]. The assessment of VF is also crucial in diagnosing osteoporosis.

Therefore, the purpose of this study was to clarify the relationship between vitamin D insufficiency/deficiency and fragility fractures. This study mainly focused on examining 25(OH)D levels in patients with fragility hip fractures. The relationship between VFs, bone mineral density (BMD), iPTH value, and the 25(OH)D value was examined. These analyses were also analyzed separately due to fracture type.

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