[Should the vitamin D level be determined for all fracture patients?].
Vitamin D deficiency is endemic worldwide. The Health Council of the Netherlands advises a colecalciferol intake of 800 IU/day and an intended serum level of calcidiol of at least 50 nmol/l for people aged 50 years and older and for osteoporosis patients. In 64% of 626 fracture patients, we found a reduced serum calcidiol level according to this definition. According to calculations based on meta-analyses, a substantial proportion of fracture patients would not achieve the target calcidiol level of 50 nmol/l with a vitamin D supplement of 800 IU/day. For example, this would be the case in 37% of elderly patients with osteoporosis. Until the results of a prospective study on this are published, we propose that fracture patients are either systematically given doses of vitamin D supplements higher than 800 IU/day, or that their serum calcidiol is measured and the dose of vitamin D supplements is adjusted according to this initial value and the desired serum concentrations, and that the measurement is repeated after 3 months so that the dosage can be adjusted if necessary.
van den Bergh
Joop
J
Universitair Medisch Centrum Maastricht, Afd. Interne Geneeskunde, subdivisie Endocrinologie, Maastricht, The Netherlands.
van Geel
Tineke
T
Geusens
Piet
P
D000368:Aged; D000375:Aging; D050071:Bone Density Conservation Agents / Q000097:blood / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D050723:Fractures, Bone / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood* / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000188:drug therapy
D050071:Bone Density Conservation Agents; D014807:Vitamin D