Prevalence of vitamin D deficiency in postmenopausal high- and low-energy fracture patient

A Summary This study evaluated the prevalence of vitamin D deficiency in postmenopausal women with fractures and revealed a high prevalence of vitamin D deficiency regardless of whether the injury mechanism was high or low energy. However, the prescription rate of vitamin D supplementation was lower in the high-energy compared to the low-energy injury group. Purpose The present study aimed to investigate the prevalence of vitamin D deficiency in postmenopausal women with fractures from low-energy and high-energy injuries and to determine differences in the prevalence of vitamin D deficiency and the rate of postoperative vitamin D supplementation between the two groups. Methods Medical records of postmenopausal women aged 50 years who presented with fractures were reviewed. One hundred and thirty-six patients were enrolled and divided into two groups according to the injury mechanism: low (107 patients) vs. high energy (29 patients). Thereafter, serum vitamin D levels, bone turnover markers, body mass index (BMI), bone mineral density, history of prior osteoporosis therapy and vitamin D supplementation, and postoperative prescription rates were compared between the two groups. Vitamin D deficiency was defined as <20 ng/mL, insufficiency as 20-30 ng/mL, and sufficiency as 30-150 ng/mL. Results The overall average vitamin D level was 22.6 ng/mL. The prevalence of vitamin D deficiency was 61.8%, and the rate of insufficiency was 14.7%, while only 23.5% of patients showed normal vitamin D levels. The prevalence of vitamin D deficiency was 60.7% and 65.5% in the low and high-energy groups (p=0.673), respectively. BMI and other laboratory measurements were similar between the two groups. Postoperative calcium and vitamin D supplementation was administered in 85.0% of patients with low-energy injury, as compared to 58.6% of those with high-energy injury (p=0.003). Osteoporosis medication was also prescribed more frequently in the low-energy group than in the high-energy group (73.8% vs. 48.3%, p=0.009). In both groups, prescription rates of calcium and vitamin D supplementation and osteoporosis medication increased after the occurrence of fracture. Conclusion Postmenopausal women with fractures have a high prevalence of vitamin D deficiency regardless of whether the mechanism of injury was high or low energy, but the prescription rate of vitamin D supplementation was lower in the high-energy than in the low-energy injury group.