title: Low levels of 25-hydroxyvitamin D are associated with the occurrence of concomitant upper limb fractures in older women who sustain a fall-related fracture of the hip.
abstract: OBJECTIVE
  To investigate the association between serum levels of 25-hydroxyvitamin D and the occurrence of simultaneous fractures of the upper limb in older women who sustain a fall-related fracture of the hip.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  We investigated 472 of 480 white women consecutively admitted to a rehabilitation hospital because of a fall-related hip fracture. Twenty-seven (5.7%) of the 472 women sustained a concomitant upper-limb fracture of either distal radius (20 women) or proximal humerus (seven women). We assessed serum levels of 25-hydroxyvitamin D 14.2 ± 4.1 (mean ± SD) days after surgical repair of the hip fracture in the 472 women by an immunoenzymatic assay.
  
  
  RESULTS
  Twenty-five-hydroxyvitamin D levels were significantly lower in the 27 women with concomitant fractures of both hip and upper limb than in the remaining 445 hip-fracture women: mean ± SD values were 6.5 ± 5.0 ng/ml and 11.7 ± 10.4 ng/ml respectively in the two groups (mean difference between groups 5.2 ng/ml: 95% CI 1.2-9.2; p=0.011). Low levels of 25-hydroxyvitamin D were significantly associated with concomitant fractures of the upper limb (p=0.017), after adjustment for eight potential confounders including age, height, weight, hip-fracture type, cognitive impairment, neurologic impairment, previous hip fracture, and previous upper-limb fracture.
  
  
  CONCLUSIONS
  Low levels of 25-hydroxyvitamin D were significantly associated with concomitant upper-limb fractures in our sample of older women with a fall-related fracture of the hip. Preventing vitamin D deficiency may lower the incidence of simultaneous fractures due to a singe fall in elderly women.
authors.affiliation: Osteoporosis Research Center, Presidio Sanitario San Camillo, Strada Santa Margherita 136, 10131 Torino, Italy. Medici@h-sancamillo.to.it
authors.forename: Marco
authors.initials: M
authors.lastname: Di Monaco
authors.forename: Fulvia
authors.initials: F
authors.lastname: Vallero
authors.forename: Carlotta
authors.initials: C
authors.lastname: Castiglioni
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Monaco
authors.forename: Rosa
authors.initials: R
authors.lastname: Tappero
mesh_terms: D000058:Accidental Falls; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000097:blood / Q000209:etiology*; D006620:Hip Fractures / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006811:Humerus; D008875:Middle Aged; D011884:Radius; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D