Vitamin D serum levels are higher in patients referring with osteoporotic fractures compared to non-fractured patients: a controlled clinical trial.

BACKGROUND: Fragility fractures are a common pathology increasing with age, but the possible association between a low dual energy X-ray absorptiometry (DEXA) level of bone mineral density (BMD) and the kind of fracture and vitamin D serum levels is not known. The study aimed to compare DEXA and vitamin D levels in patients with and without osteoporotic fractures. METHODS: DEXA and vitamin D levels of 223 patients with osteoporotic fractures were compared to 262 osteoporotic patients without a known fracture. The 223 patients with osteoporotic fractures were 76 years old on average. For each patient, epidemiologic, clinical, laboratory, Fracture Risk Assessment Tool (FRAX) values and densitometric parameters were analyzed. A statistical evaluation was performed. RESULTS: On average the femoral T score was -1.8, the vertebral T score was -1.6, and the vitamin D level was 42.2 ng/mL. The osteoporotic patients without a fracture were 262 with an average age of 65. The T femoral score was -1.1 and the T vertebral score was -1.2. The level of vitamin D was 33. There is a significant difference between the vitamin D dosage values between the two groups (P=0.036); in addition, there is a significant difference between the femoral T score values (P=0.00000069), while there is no statistically significant difference between the vertebral T score values (P=0.058). Osteoporotic fractures can be found even with osteopenia and good levels of vitamin D. CONCLUSIONS: Vitamin D dosage values are unexpectedly lower in outpatients than in fractured patients. The advanced age of fractured patients (average of 76 years) compared to the age of outpatients (65 years on average) shows that the age parameter is a strong risk indicator for fragility fractures.