Assessing the Predictive Value of Serum Vitamin D Levels for Hip Fracture Risk in Older Adults and Identifying Associated Risk Factors

TL;DR

This study finds that low vitamin D levels are common in older adults with hip fractures and suggests that vitamin D screening and supplementation could help reduce fracture risk.

Contribution

The study identifies vitamin D deficiency as a significant modifiable risk factor for hip fractures in older adults and emphasizes the need for personalized supplementation strategies.

Findings

Older adults with hip fractures had significantly lower vitamin D levels than recommended.

Comorbidities like diabetes and chronic kidney disease were associated with lower vitamin D levels.

Vitamin D supplementation showed positive effects but with variable responses, suggesting personalized approaches.

Abstract

Background

As the elderly population continues to grow globally, the incidence of hip fractures among this demographic is becoming an increasingly pressing public health issue. Hip fractures often result from a complex interplay of factors, including sociodemographic variables, clinical comorbidities, medication use, physical activity, and vitamin D levels. Understanding these factors is essential to mitigating the risk of hip fractures in older individuals.

Objective
This study aims to explore the relationship between vitamin D levels and hip fracture risk in elderly patients, identifying the clinical, demographic, and environmental factors contributing to fracture risk, with a particular focus on the role of vitamin D in bone health.

Methodology
This cross-sectional observational study was conducted at Mardan Medical Complex between January 2024 and February 2025. A total of 119 older adult patients (aged 50 years and above) with confirmed hip fractures were included. Demographic data, comorbidities, vitamin D levels, and relevant biomarkers were collected. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using electrochemiluminescence immunoassay. Statistical analysis, including ANOVA, Mann-Whitney U tests, and decision tree modeling, was employed to assess the relationship between vitamin D and other variables, including BMI, mobility, supplementation, and comorbidities.

Results
The study found a high prevalence of vitamin D deficiency among older adult patients with hip fractures, with the average serum vitamin D level measured at 15.01 ± 5.51 ng/mL, significantly lower than the recommended levels. Key factors such as Body Mass Index (BMI) (28.27 ± 5.67) and mobility status (59 patients, 49.58% using mobility aids), as well as comorbidities like diabetes (76 patients, 63.87%) and chronic kidney disease (18 patients, 15.13%), were significantly associated with lower vitamin D levels. Vitamin D supplementation, with an average intake of 505.99 ± 284.26 IU/day, was taken by 68 patients (57.14%) and showed a positive effect on serum levels, but the variability in response (ranging from non-users to varying doses) highlighted the need for personalized supplementation strategies. Additionally, age (67.53 ± 10.51 years) and gender (69 males, 57.98%, and 50 females, 42.02%) did not show a significant impact on vitamin D levels or fracture risk in this study.

Conclusion
This study supports the importance of vitamin D as a modifiable risk factor for hip fractures in older adult patients. It underscores the need for comprehensive public health strategies, including regular vitamin D screening, targeted supplementation, and management of comorbidities, to reduce fracture risk in aging populations.

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