Abstract
Hip fracture has increasingly become a social and economic burden. The relationship between serum 25-hydroxyvitamin D levels and the risk of hip fracture reported by previous studies remains controversial. We searched Pubmed and Embase to identify studies reporting the relationship between serum 25-hydroxyvitamin D levels and risk of hip fracture. Fifteen prospective cohort studies with a total of 51239 participants and 3386 hip fracture cases were included. By pooling the Relative Risk of the lowest vs. the highest categories indicated that lower levels of serum 25-hydroxyvitamin D were more likely to be a risk factor for hip fracture with adjusted Relative Risk (95%Confidence Interval) of 1.58 (1.41, 1.77). Subgroup meta-analysis examining the stability of the primary results achieved the same results. A dose-response meta-analysis showed that the risk of hip fracture was a descending curve below the line of RR=1. The descending trend was obvious when serum 25-hydroxyvitamin D levels were less than 60 nmol/L and was flat when serum 25-hydroxyvitamin D levels were more than 60 nmol/L. We found that individuals with low levels of serum 25-hydroxyvitamin D have an increased risk of hip fracture, and this effect was evident when the serum 25-hydroxyvitamin D levels were less than 60 nmol/L.
Highlights
Hip fracture as a serious consequence of osteoporosis is becoming an important health problem, and an increasing social and economic burden [1,2,3], and hip fractures are expected to receive more attention over the coming years [4,5,6]
There were 74 articles excluded, including review articles, studies that examined other types of fractures and 25(OH)D, 17 non-prospective cohort studies, 2 meeting articles, 17 articles about other factors affecting the bone health and 25(OH)D, and 15 studies research the prevalence of vitamin D insufficiency in patient of any kind of fracture
A total of 51239 participants were included in our meta-analysis, of whom 3386 had a hip fracture
Summary
Hip fracture as a serious consequence of osteoporosis is becoming an important health problem, and an increasing social and economic burden [1,2,3], and hip fractures are expected to receive more attention over the coming years [4,5,6]. Multiple factors have been shown to be associated with the risk of hip fractures [8,9,10,11]. It is widely recognized that vitamin D plays an important role in skeletal health [1215]. Serum 25-hydroxyvitamin D [25(OH)D] is widely recognized as the indicator of vitamin D [16]. In study of Barbour et al [19], they found no evidence of an association between 25(OH)D and any non-spine fractures, and similar result was found in studies of Cummings et al [20] (25(OH)D less than 47.5 nmol/L (19 ng/ml) with RR: 1.2 (0.7-1.9)), Chan et al [21] with (RR: 0.63 (0.15-2.62)), and de Boer et al [22] with (RR: 1.34 (0.97-1.84))
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