Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017

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The serum 25-hydroxyvitamin D levels and hip fracture risk: a meta-analysis of prospective cohort studies - 58% March 2017

Oncotarget doi: 10.18632/oncotarget.16337
Qing-Bo Lv1, Xiang Gao1, Xiang Liu1, Zhen-Xuan Shao1, Qian-Hui Xu1, Li Tang1, Yong-Long Chi1 and Ai-Min Wu1
1 Department of Orthopedics, Bone Research Institute, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Second Medical School of Wenzhou Medical University, Wenzhou, Zhejiang, China
Correspondence to: Ai-Min Wu, email: aiminwu2005@163.com

Hip fracture has increasingly become a social and economic burden. The relationship between serum 25-hydroxyvitamin D levels and the risk of hip fracture reported by previous studies remains controversial. We searched Pubmed and Embase to identify studies reporting the relationship between serum 25-hydroxyvitamin D levels and risk of hip fracture. Fifteen prospective cohort studies with a total of 51239 participants and 3386 hip fracture cases were included.

By pooling the Relative Risk of the lowest vs. the highest categories indicated that lower levels of serum 25-hydroxyvitamin D were more likely to be a risk factor for hip fracture with adjusted Relative Risk (95% Confidence Interval) of 1.58 (1.41, 1.77). Subgroup meta-analysis examining the stability of the primary results achieved the same results. A dose-response meta-analysis showed that the risk of hip fracture was a descending curve below the line of RR=1. The descending trend was obvious when serum 25-hydroxyvitamin D levels were less than 60 nmol/L and was flat when serum 25-hydroxyvitamin D levels were more than 60 nmol/L. We found that individuals with low levels of serum 25-hydroxyvitamin D have an increased risk of hip fracture, and this effect was evident when the serum 25-hydroxyvitamin D levels were less than 60 nmol/L.

Relative risk vs blood level (nmol)

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Hiip fracture risk increased 48% if low vitamin D - meta-analysis May 2017

The associations between serum 25-hydroxyvitamin D level and the risk of total fracture and hip fracture.
Osteoporos Int. 2017 May;28(5):1641-1652. doi: 10.1007/s00198-017-3955-x. Epub 2017 Feb 20.
Feng Y1, Cheng G1, Wang H1, Chen B2.

In this meta-analysis, we evaluated the association between serum 25-hydroxyvitamin D (25(OH) vitamin D) level and the risk of total fractures and hip fractures. Low serum 25(OH) vitamin D level is associated with an increased risk of total and hip fractures.

INTRODUCTION:
Data on the association between serum 25(OH) vitamin D level and the risk of fractures are conflicting. This study aimed to provide a summary of prospective cohort or nested case-control studies on the association between serum 25(OH) vitamin D level and the risk of total fractures and hip fractures.

METHODS:
We identified relevant studies by searching the PubMed, EMBASE, and OVID databases from their inception to June 1, 2016. We included published prospective cohort or nested case-control studies evaluating the associations of serum 25(OH) vitamin D level with the fracture risk. Two reviewers abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were derived throughout the whole analysis.

RESULTS:
Sixteen prospective cohort studies and three nested case-control studies were included. We found that low serum 25(OH) vitamin D level was significantly associated with the risk of total fractures (RR 1.25, 95% CI 1.06-1.43; I 2 = 31.3%, p for heterogeneity = 0.15) and hip fractures (RR 1.48, 95% CI 1.29-1.68; I 2 = 0%, p for heterogeneity = 0.51). The hip fracture risk was increased by 40% for each SD decrease in serum 25(OH) vitamin D level (RR 1.40, 95% CI 1.20-1.61; I 2 = 0%, p for heterogeneity = 0.51). The per SD decrease in serum 25(OH) vitamin D level was not associated with the increased risk of total fractures (RR 1.14, 95% CI 0.93-1.35; I 2 = 63.2%, p for heterogeneity = 0.04).

CONCLUSIONS:
Our study suggests that low serum 25(OH) vitamin D level is associated with increased risks of total and hip fractures. In the analyzed studies, the per SD decrease in serum 25(OH) vitamin D level was associated with the hip fracture risk but not with the total fracture risk.

PMID: 28220196 DOI: 10.1007/s00198-017-3955-x Publisher wants $40 for the PDF]

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