Archives of Osteoporosis

, 13:109 | Cite as

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

  • Jun Seung Lee
  • Ji Wan KimEmail author
Original Article



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.


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.


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.


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.


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.


Fracture Vitamin D Osteoporosis Treatment 


Compliance with ethical standards

Conflicts of interest

Jun Seung Lee declares that he has no conflict of interest. Ji Wan Kim declares that this study was supported by research funding from Korean Society for Bone and Mineral Research.


  1. 1.
    Brown AJ, Dusso A, Slatopolsky E (1999) Vitamin D. Am J Phys 277:F157–F175Google Scholar
  2. 2.
    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281. CrossRefPubMedGoogle Scholar
  3. 3.
    Marcelli C, Chavoix C, Dargent-Molina P (2015) Beneficial effects of vitamin D on falls and fractures: is cognition rather than bone or muscle behind these benefits? Osteoporos Int 26:1–10. CrossRefPubMedGoogle Scholar
  4. 4.
    Brinker MR, O'Connor DP, Monla YT, Earthman TP (2007) Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma 21:557–570. CrossRefPubMedGoogle Scholar
  5. 5.
    Schindeler A, McDonald MM, Bokko P, Little DG (2008) Bone remodeling during fracture repair: the cellular picture. Semin Cell Dev Biol 19:459–466. CrossRefPubMedGoogle Scholar
  6. 6.
    Gorter EA, Hamdy NA, Appelman-Dijkstra NM, Schipper IB (2014) The role of vitamin D in human fracture healing: a systematic review of the literature. Bone 64:288–297. CrossRefPubMedGoogle Scholar
  7. 7.
    Dixon T, Mitchell P, Beringer T, Gallacher S, Moniz C, Patel S, Pearson G, Ryan P (2006) An overview of the prevalence of 25-hydroxy-vitamin D inadequacy amongst elderly patients with or without fragility fracture in the United Kingdom. Curr Med Res Opin 22:405–415. CrossRefPubMedGoogle Scholar
  8. 8.
    Beringer T, Heyburn G, Finch M, McNally C, McQuilken M, Duncan M, Dixon T (2006) Prevalence of vitamin D inadequacy in Belfast following fragility fracture. Curr Med Res Opin 22:101–105. CrossRefPubMedGoogle Scholar
  9. 9.
    Gallacher SJ, McQuillian C, Harkness M, Finlay F, Gallagher AP, Dixon T (2005) Prevalence of vitamin D inadequacy in Scottish adults with non-vertebral fragility fractures. Curr Med Res Opin 21:1355–1361. CrossRefPubMedGoogle Scholar
  10. 10.
    Moniz C, Dew T, Dixon T (2005) Prevalence of vitamin D inadequacy in osteoporotic hip fracture patients in London. Curr Med Res Opin 21:1891–1894. CrossRefPubMedGoogle Scholar
  11. 11.
    Gorter EA, Krijnen P, Schipper IB (2016) Vitamin D deficiency in adult fracture patients: prevalence and risk factors. Eur J Trauma Emerg Surg 42:369–378. CrossRefPubMedGoogle Scholar
  12. 12.
    Bischoff-Ferrari HA, Can U, Staehelin HB, Platz A, Henschkowski J, Michel BA, Dawson-Hughes B, Theiler R (2008) Severe vitamin D deficiency in Swiss hip fracture patients. Bone 42:597–602. CrossRefPubMedGoogle Scholar
  13. 13.
    ter Bor EJ, van den Hoeven-van Kasteel W, Kelder JC, Lems WF (2015) Prevalence and correction of severe hypovitaminosis D in patients over 50 years with a low-energy fracture. Neth J Med 73:124–128PubMedGoogle Scholar
  14. 14.
    Simonelli C, Weiss TW, Morancey J, Swanson L, Chen YT (2005) Prevalence of vitamin D inadequacy in a minimal trauma fracture population. Curr Med Res Opin 21:1069–1074. CrossRefPubMedGoogle Scholar
  15. 15.
    Bergstrom U, Bjornstig U, Stenlund H, Jonsson H, Svensson O (2008) Fracture mechanisms and fracture pattern in men and women aged 50 years and older: a study of a 12-year population-based injury register, Umea, Sweden. Osteoporos Int 19:1267–1273. CrossRefPubMedGoogle Scholar
  16. 16.
    Bauer GC (1954) Rate of bone salt formation in a healing fracture determined in rats by means of radiocalcium. Acta Orthop Scand 23:169–191CrossRefGoogle Scholar
  17. 17.
    Nikolaou VS, Efstathopoulos N, Kontakis G, Kanakaris NK, Giannoudis PV (2009) The influence of osteoporosis in femoral fracture healing time. Injury 40:663–668. CrossRefPubMedGoogle Scholar
  18. 18.
    Giannoudis P, Tzioupis C, Almalki T, Buckley R (2007) Fracture healing in osteoporotic fractures: is it really different? A basic science perspective. Injury 38(Suppl 1):S90–S99. CrossRefPubMedGoogle Scholar
  19. 19.
    Lemaire RG (1966) Calcium metabolism in fracture healing. An experimental kinetic study in rats, using Ca45. J Bone Joint Surg Am 48:1156–1170CrossRefGoogle Scholar
  20. 20.
    Solomon DH, Finkelstein JS, Katz JN, Mogun H, Avorn J (2003) Underuse of osteoporosis medications in elderly patients with fractures. Am J Med 115:398–400CrossRefGoogle Scholar
  21. 21.
    LeBoff MS, Hawkes WG, Glowacki J, Yu-Yahiro J, Hurwitz S, Magaziner J (2008) Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 19:1283–1290. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Kim A, Yun JM (2017) Association of diabetes with serum vitamin D in Korean adults: analysis of the Korea National Health and Nutrition Examination Survey (2013~2014). J Korean Diet Assoc 23:39–53. CrossRefGoogle Scholar
  23. 23.
    Mechanick JI, Camacho PM, Cobin RH, Garber AJ, Garber JR, Gharib H, Petak SM, Rodbard HW, Trence DL, American Association of Clinical Endocrinologists (2010) American association of clinical endocrinologists protocol for standardized production of clinical practice guidelines--2010 update. Endocr Pract 16:270–283. CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
  2. 2.Department of Orthopedic Surgery, Asan Medical Center, College of MedicineUniversity of UlsanSeoulRepublic of Korea

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