Low vitamin D status is ‘prevalent’ in trauma patients
A study monitoring the vitamin D status in over 1800 trauma over nearly 2 years has found that many people suffering from orthopaedic trauma have below optimal levels of the sunshine vitamin. Speaking at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the team of US researchers reported that that just over 77% of trauma patients had deficient or insufficient levels of vitamin D.
"Vitamin D deficiency affects patients of all ages and is more prevalent than we thought it was," said Dr. Brett Crist, from the University of Missouri, USA – who led the research team.
He added that the results of the study are of importance, especially as vitamin D deficiency has been linked to increased incidences of bone breaks that fail to heal (fracture nonunions).
Crist said the new data, showing that a significant number of patients have deficient or insufficient levels of vitamin D, means that health care professionals should consider treating fracture patients with a supplement to ensure optimal outcome.
He said vitamin D deficiency is "easy to manage" and "can prevent future fractures and improve healing of current fractures."
Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Both D3 and D2 precursors are transformed in the liver and kidneys into 25- hydroxyvitamin D (25(OH)D), the non-active 'storage' form, and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active form that is tightly controlled by the body.
The essential role of vitamin D in bone metabolism and calcium homeostasis has been known for many years, with Crist noting that various researchers “have demonstrated a correlation between vitamin D deficiency and muscle weakness, fragility fractures and fracture non-union.”
As a result he believes that establishing the incidence of vitamin D deficiency in people suffering from trauma (such as broken or fractured bones) “is of significant importance to raise awareness of the disease, and change screening and treatment patterns.”
Crist and his team reviewed the medical records of 1,830 adult trauma patients at the University of Missouri trauma centre over the course of 21 months (from Jan 2009 to Sept 2010). They noted that participants with vitamin D levels below 20 ng/mL were categorized as ‘deficient’, whilst those with levels between 20 and 32 ng/mL ‘insufficient’, (levels between 40 and 70 ng/mL are considered ‘healthy’).
“To our knowledge, this is the largest patient population of orthopaedic trauma patients to be evaluated for vitamin D deficiency,” noted Crist.
He reported that 39% of all patients were vitamin D deficient, and another 38.4 percent had insufficient levels of vitamin D – a combined deficiency and insufficiency had an overall prevalence of 77.4%, they noted.
“Both vitamin D deficiency and insufficiency was prevalent in this large population of orthopaedic trauma patients,” he confirmed, noting that the study time frame of 21 months “helps to account for seasonal variation in the prevalence of vitamin D deficiency.”
Source: Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS)
“Prevalence of Vitamin D Deficiency in Orthopaedic Trauma Patients”
Authors: B.D Crist, M.A. Hood, Y.M. Murtha, G.J. Della Rocca, J.P. Stannard