股関節骨折患者におけるビタミンD欠乏症の有病率、予測因子、および12ヶ月転帰への臨床的影響
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 ほか — Journal of endocrinological investigation
AI要約
この研究により、股関節骨折を経験した高齢者の半数以上がビタミンD欠乏症であることが判明しました。当初、ビタミンD欠乏症は死亡率の上昇と関連があるように見えましたが、他の健康状態を考慮すると、この関連性はほとんどなくなりました。しかし、リスクの高い股関節骨折患者においてビタミンD欠乏症を特定し、補充することは依然として重要です。
AI生成の要約です — 原文を読む
Abstract（原文）
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.
このコラムに関連する書籍
ビタミンD不足が招く病気――骨・免疫・うつに効く正しい補充法
骨代謝・予防医学関連書籍
ビタミンD欠乏の実態と健康への影響を最新研究で解説。食事・日光浴・サプリの正しい使い分けも紹介。
Amazonで本を見るビタミンDが摂れる魚・きのこレシピ
管理栄養士監修
鮭・さんま・しいたけなどビタミンDが豊富な食材を使ったレシピを季節ごとに紹介。
Amazonで本を見るAmazonのアソシエイトとして、栄養DBは適格販売により収入を得ています。
出典: PubMed (PMID: 42364060)。AI要約は情報提供のみを目的とし、医療的アドバイスを構成するものではありません。