Resumen de Serum of 25-Hydroxyvitamin D and Intact Parathyroid Hormone Levels in Postmenopausal Women with Hip and Upper Limb Fractures

Jiang-Tao Lv--, YingYing Zhang, Shao-Qi Tian, Kang Sun-

• Objectives To assess the serum of 25-hydroxyvitamin D (25(OH)D) and intact parathyroid hormone (iPTH) levels in postmenopausal women from northern China with hip and upper limb fractures.

  Design Case–control.

  Setting Affiliated Hospital of Qingdao University.

  Participants Postmenopausal women diagnosed with hip fracture (n = 335) and matched controls without fracture (n = 335).

  Measurements Between 2011 and 2013, fasting venous samples were analyzed for 25(OH)D, iPTH, alkaline phosphatase (ALP), calcium, and phosphorus. All women completed a standardized questionnaire designed to document putative risk factors for fractures.

  Results Eight percent of participants had vitamin D deficiency, and 66.0% had secondary hyperparathyroidism. Serum 25(OH)D levels were significantly (P < .001) lower in women with hip fracture than in controls. Multivariate logistic regression analysis adjusted for common risk factors showed that serum 25(OH)D of 20 ng/mL or less was an independent indicator of hip fracture (odds ratio (OR) = 2.98, 95% confidence interval (CI) = 2.11–4.20) and concomitant upper limb fracture in those with existing hip fractures (OR = 4.77, 95% CI = 1.60–10.12). The area under the receiver operating characteristic curve of 25(OH)D was 0.77 (95% CI = 0.68–0.84) for hip fracture and 0.80 (95% CI = 0.72–0.89) for hip and upper limb fractures.

  Conclusion Vitamin D insufficiency and secondary hyperparathyroidism were a common problem in postmenopausal women who presented with concomitant hip and upper limb fractures, suggesting that they might contribute to the pathophysiology of fractures in postmenopausal women.