Abstract
Background: Vitamin D deficiency is associated with an increased risk of falls and hip fractures in older adults. Risk factors are suboptimal sunlight exposure and the lower cutaneous synthesis of vitamin D, reduced dietary intake of D2 (ergocalciferol) and D3 (cholecalciferol), impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys. The present study's objective was to determine the frequency of vitamin D levels in females with hip fractures presenting to a tertiary care facility in Karachi, Pakistan.
 Methodology: A cross-sectional study was conducted at the Orthopaedic Surgery Department of Jinnah Postgraduate Medical Center, Karachi, from 17th May to 16th November 2016. A total of 123 females with Hip fracture of ≤ 4 weeks were included in this study. Patient's age, occupation, education level, and comorbidities like diabetes mellitus (DM), hypertension (HTN), and Vitamin D levels were observed. The patient was labeled with vitamin D sufficiency, insufficiency, and deficiency on the basis of Vitamin D levels. Stratification was done, and the post-stratification Chi-square test was applied.
 Results: The mean age of study participant was 60.32 ± 9.14 years and the mean duration of fracture was 12.27 ± 5.84 days, Body Mass Index (BMI) was 24.57 ± 2.77 kg/m2, vitamin D level was 18.28 ± 8.10 ng/ml. Only 8.9% were found with sufficient vitamin D levels. Insufficiency was found in 28.5% of patients. Vitamin D deficiency was found in 62.6% of patients.
 Conclusion: Vitamin D deficiency is common in elderly female patients with hip fractures and is associated with age and DM. This initial work warrants further larger-scale studies of vitamin D variations.
Highlights
Vitamin D deficiency is associated with increased muscle weakness and pain leading to reduced strength, balance, and function[1]; increased bone turnover[2,3], and increased risk of falls and hip fractures in older adults[4]
People are at greater risk of vitamin D deficiency because of risk factors such as suboptimal sunlight exposure and the lower cutaneous synthesis of vitamin D, reduced dietary intake of D2 and D3, impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys[1]
Consecutive female patients with the age between 45-75 years with duration of fracture ≤ 04 weeks admitted through the emergency department of JPMC meeting the inclusion criteria were included in the study while Patients with End-Stage Renal Disease (ESRD) requiring Renal Replacement Therapy (RRT) (GFR < 15) and high-impact injuries were excluded from the study
Summary
Vitamin D deficiency is associated with increased muscle weakness and pain leading to reduced strength, balance, and function[1]; increased bone turnover[2,3], and increased risk of falls and hip fractures in older adults[4]. People are at greater risk of vitamin D deficiency because of risk factors such as suboptimal sunlight exposure and the lower cutaneous synthesis of vitamin D, reduced dietary intake of D2 (ergocalciferol) and D3 (cholecalciferol), impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys[1]. Risk factors are suboptimal sunlight exposure and the lower cutaneous synthesis of vitamin D, reduced dietary intake of D2 (ergocalciferol) and D3 (cholecalciferol), impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys. Conclusion: Vitamin D deficiency is common in elderly female patients with hip fractures and is associated with age and DM. This initial work warrants further larger-scale studies of vitamin D variations
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