Abstract
Objective
To determine the risk factors for the presence of moderate/severe vertebral fracture,
specifically 25-hydroxyvitamin D (25-OHD).
Study design
Cross-sectional study conducted for 2 years in the city of São Paulo, Brazil including
community-dwelling elderly women.
Methods
Bone mineral density (BMD), serum 25-OHD, intact parathyroid hormone (iPTH), calcium
and estimated glomerular filtration rate (eGFR) were examined in 226 women without
vertebral fractures (NO FRACTURE group) and 189 women with at least one moderate/severe
vertebral fracture (FRACTURE group). Vertebral fracture assessment (VFA) was evaluated
using both the Genant semiquantitative (SQ) approach and morphometry.
Results
Patients in the NO FRACTURE group had lower age, increased height, higher calcium
intake, and higher BMD compared to those patients in the FRACTURE group (p < 0.05). Of interest, serum levels of 25-OHD in the NO FRACTURE group were higher than
those observed in the FRACTURE group (51.73 nmol/L vs. 42.31 nmol/L, p < 0.001). Reinforcing this finding, vitamin D insufficiency (25-OHD < 75 nmol/L) was observed less in the NO FRACTURE group (82.3% vs. 93.65%, p = 0.001). After adjustment for significant variables within the patient population (age,
height, race, calcium intake, 25-OHD, eGFR and sites BMD), the logistic-regression
analyses revealed that age (OR = 1.09, 95% CI 1.04–1.14, p < 0.001) femoral neck BMD (OR = 0.7, 95% CI 0.6–0.82, p < 0.001) and 25-OHD <75 nmol/L (OR = 2.38, 95% CI 1.17–4.8, p = 0.016) remains a significant factor for vertebral fracture.
Conclusion
Vitamin D insufficiency is a contributing factor for moderate/severe vertebral fractures.
This result emphasizes the importance of including this modifiable risk factor in
the evaluation of elderly women.
Keywords
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Article info
Publication history
Published online: October 16, 2009
Accepted:
September 28,
2009
Received in revised form:
September 21,
2009
Received:
May 12,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
