Vitamin D2026-06

Prevalence, predictors, and clinical impact of vitamin D deficiency on 12-month outcomes in hip fracture patients.

Arcidiacono Gaetano Paride, Torres Marco Onofrio, Ceolin Chiara, Tripepi Giovanni et al. — Journal of endocrinological investigation

Summary

This study found that over half of hip fracture patients had vitamin D deficiency. While initial findings suggested a link between vitamin D deficiency and higher mortality, this connection was largely explained by other existing health problems. The research emphasizes the importance of recognizing and addressing vitamin D deficiency in these vulnerable patients.

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Key points

More than half of hip fracture patients in this study had a vitamin D deficiency.
Factors like male sex, diabetes, dementia, and smoking were linked to a higher risk of vitamin D deficiency.
While vitamin D deficiency was initially associated with higher mortality, this link was largely explained by other existing health conditions.
Taking vitamin D supplements before the study was associated with a lower risk of deficiency.

What the study looked at

This study aimed to understand how common vitamin D deficiency is among older adults who have suffered a hip fracture, what factors might predict it, and if it affects their health outcomes over the following year. Researchers followed 934 patients hospitalized for a hip fracture over a year. They measured vitamin D levels in their blood and collected information on their health conditions, lifestyle, and other factors. Vitamin D deficiency was defined as blood levels below a certain threshold. The study found that over half of these hip fracture patients had vitamin D deficiency. Factors like being male, having diabetes or dementia, and smoking were linked to a higher chance of deficiency, while taking vitamin D supplements beforehand was protective. Although initial analyses suggested a link between vitamin D deficiency and higher mortality within 12 months, this connection largely disappeared when other health issues and age were taken into account. The study did not find a link between vitamin D deficiency and the risk of being re-hospitalized or having another fracture.

Dietary takeaway

This study highlights that vitamin D deficiency is very common among hip fracture patients, suggesting that ensuring adequate vitamin D intake is crucial for this vulnerable group. While dietary sources like fatty fish, fortified milk, and some mushrooms can contribute, supplementation might be necessary, especially for those at higher risk. Remember, this is one study, and more research is always needed to draw definitive conclusions about specific dietary recommendations.

Abstract

PURPOSE: Vitamin D deficiency (VDD) is common in older adults with osteoporosis, but its prevalence, determinants, and clinical impact in hip fracture (HF) patients remain incompletely defined. This study investigated the prevalence of VDD, associated factors, and 12-month outcomes in HF patients managed within a Fracture Liaison Service program. METHODS: In this prospective cohort study, 934 patients hospitalized for HF were enrolled between March 2023 and March 2025. VDD was defined as serum 25-hydroxyvitamin D [25-(OH)D] < 50 nmol/L. Clinical characteristics, laboratory parameters, and 12-month outcomes were assessed. RESULTS: Overall VDD prevalence was 53.6%, with a median 25-(OH)D concentration of 22 nmol/L among deficient patients. Independent predictors of VDD were male sex (p < 0.001), diabetes mellitus (p = 0.003), dementia (p = 0.013), and active smoking (p = 0.045), while prior vitamin D supplementation was negatively associated (p < 0.001). Decision tree analysis showed VDD prevalence ranging from 17.2% to 86.3% across patient phenotypes. Patients with VDD showed higher levels of bone turnover markers. In unadjusted analyses, VDD was associated with higher 12-month mortality (HR 1.65, 95% CI 1.12-2.42, p = 0.010), an association attenuated and no longer significant after adjustment for age, sex, and comorbidity burden (HR 1.31, 95% CI 0.88-1.96, p = 0.188). No associations were observed between VDD and rehospitalization or refracture rates. CONCLUSION: VDD is highly prevalent in HF patients. Although associated with higher mortality in unadjusted analyses, this relationship appears largely explained by comorbidity burden. These findings highlight the importance of recognizing VDD and implementing targeted vitamin D supplementation strategies in high-risk HF populations.

View on PubMed →DOI: 10.1007/s40618-026-02952-x