The Relationship Between Serum Vitamin D and Fracture Risk in the Elderly: a Meta-analysis

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2020 Feb 28

PMID 32103764

Citations 27

Authors

Ning Wang

Yungang Chen

Jindou Ji

Jinlei Chang

Shengwen Yu

Bo Yu

Affiliations

Soon will be listed here.

Abstract

Background: The incidence of osteoporotic fractures has increased rapidly, and because of the poor prognosis and high mortality associated with osteoporotic fractures, they remain a prospective research area globally. One way to reduce their incidence is to investigate their intervention risk factors in the elderly. Hence, this study explores the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and osteoporotic fractures in elderly patients through a meta-analysis.

Methods: We conducted our literature search mainly in PubMed and Embase for identifying studies that investigated the relationship between serum 25(OH)D levels and the risk for osteoporotic fractures. We performed categorical analysis, heterogeneity checks, publication bias analysis, and subgroup analyses.

Results: In total, 20 studies were included, of which 4 were case-cohort studies and 16 were cohort studies. A total of 41,738 patients from 20 studies were included in the meta-analysis, of which 5916 had fractures, including 3237 hip fractures. By combining the lowest and highest categories of relative risks (RRs) and 95% confidence intervals (CIs), it was suggested that lower serum 25-hydroxyvitamin D levels may be a risk factor for fractures. RR (95% CI) for total and hip fractures were 1.11 (0.99, 1.24) and 0.89 (0.80, 0.98) after adjustments.

Conclusions: Our study showed that compared to low serum 25(OH)D levels, high serum 25(OH)D levels reduce the risk of hip fractures in the patients aged 60 years or older. In contrast, serum 25(OH)D has no significant relationship with total fracture risk.

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References

McNutt L, Wu C, Xue X, Hafner J . Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003; 157(10):940-3. DOI: 10.1093/aje/kwg074. View

Tanner S, Harwell S . More than healthy bones: a review of vitamin D in muscle health. Ther Adv Musculoskelet Dis. 2015; 7(4):152-9. PMC: 4530385. DOI: 10.1177/1759720X15588521. View

Holick M . Vitamin D deficiency. N Engl J Med. 2007; 357(3):266-81. DOI: 10.1056/NEJMra070553. View

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

Cummings S, Browner W, Bauer D, Stone K, Ensrud K, Jamal S . Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1998; 339(11):733-8. DOI: 10.1056/NEJM199809103391104. View

Garnero P, Munoz F, Sornay-Rendu E, Delmas P . Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone. 2006; 40(3):716-22. DOI: 10.1016/j.bone.2006.09.026. View

Sozen T, Ozisik L, Calik Basaran N . An overview and management of osteoporosis. Eur J Rheumatol. 2017; 4(1):46-56. PMC: 5335887. DOI: 10.5152/eurjrheum.2016.048. View

Nakamura K, Saito T, Oyama M, Oshiki R, Kobayashi R, Nishiwaki T . Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int. 2010; 22(1):97-103. DOI: 10.1007/s00198-010-1213-6. View

Feng Y, Cheng G, Wang H, Chen B . The associations between serum 25-hydroxyvitamin D level and the risk of total fracture and hip fracture. Osteoporos Int. 2017; 28(5):1641-1652. DOI: 10.1007/s00198-017-3955-x. View

10.

Bischoff-Ferrari H, Willett W, Wong J, Giovannucci E, Dietrich T, Dawson-Hughes B . Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005; 293(18):2257-64. DOI: 10.1001/jama.293.18.2257. View

11.

Olmos J, Hernandez J, Garcia-Velasco P, Martinez J, Llorca J, Gonzalez-Macias J . Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults. Osteoporos Int. 2015; 27(1):105-13. DOI: 10.1007/s00198-015-3219-6. View

12.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

13.

Knobloch K, Yoon U, Vogt P . Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and publication bias. J Craniomaxillofac Surg. 2010; 39(2):91-2. DOI: 10.1016/j.jcms.2010.11.001. View

14.

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

15.

Holvik K, Ahmed L, Forsmo S, Gjesdal C, Grimnes G, Samuelsen S . Low serum levels of 25-hydroxyvitamin D predict hip fracture in the elderly: a NOREPOS study. J Clin Endocrinol Metab. 2013; 98(8):3341-50. DOI: 10.1210/jc.2013-1468. View

16.

Bleicher K, Cumming R, Naganathan V, Blyth F, Le Couteur D, Handelsman D . U-shaped association between serum 25-hydroxyvitamin D and fracture risk in older men: results from the prospective population-based CHAMP study. J Bone Miner Res. 2014; 29(9):2024-31. DOI: 10.1002/jbmr.2230. View

17.

Cauley J, Parimi N, Ensrud K, Bauer D, Cawthon P, Cummings S . Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men. J Bone Miner Res. 2009; 25(3):545-53. PMC: 3121172. DOI: 10.1359/jbmr.090826. View

18.

Lv Q, Gao X, Liu X, Shao Z, Xu Q, Tang L . The serum 25-hydroxyvitamin D levels and hip fracture risk: a meta-analysis of prospective cohort studies. Oncotarget. 2017; 8(24):39849-39858. PMC: 5503658. DOI: 10.18632/oncotarget.16337. View

19.

Sutton A, Duval S, Tweedie R, Abrams K, Jones D . Empirical assessment of effect of publication bias on meta-analyses. BMJ. 2000; 320(7249):1574-7. PMC: 27401. DOI: 10.1136/bmj.320.7249.1574. View

20.

Looker A . Serum 25-hydroxyvitamin D and risk of major osteoporotic fractures in older U.S. adults. J Bone Miner Res. 2012; 28(5):997-1006. DOI: 10.1002/jbmr.1828. View