title: Is there an epidemic vitamin D deficiency in German orthopaedic patients?
abstract: BACKGROUND
  Vitamin D plays an essential role in bone health and muscle function. Some studies have shown a widespread rate of vitamin D deficiency in the general population, but few have reported on the vitamin D status of orthopaedic patients.
  
  
  OBJECTIVE
  We investigated (1) the extent of hypovitaminosis D in orthopaedic patients, (2) seasonal variations in vitamin D levels, and (3) possible risk factors for insufficient vitamin D levels.
  
  
  METHODS
  Vitamin D levels in 1119 patients consecutively admitted to an orthopaedic surgery department in 2011 were measured. To investigate the correlation between climate factors and vitamin D levels, the sunshine hours for each month in 2011 were collected by Deutscher Wetterdienst (the German weather service) in the region where most tested patients lived. The prevalence of normal (> 30 ng/mL), insufficient (20-30 ng/mL), and deficient (< 20 ng/mL) 25-hydroxyvitamin D levels was determined. Univariate and multivariate analyses were used to assess risk factors for insufficient vitamin D levels.
  
  
  RESULTS
  Overall, 84% of patients had insufficient levels of vitamin D and 60% were vitamin D deficient. Only 15% were in the target range of 30 to 60 ng/mL. The prevalence of low vitamin D levels was greater during winter and months with fewer sunshine hours. Vitamin D levels did not vary according to age, sex, and disease. Individuals with obesity, hypertension, and osteoporosis were more likely to have low vitamin D levels compared with their healthy counterparts.
  
  
  CONCLUSIONS
  There is an alarmingly high rate of hypovitaminosis D and vitamin D deficiency among orthopaedic patients in this region of Germany, whose latitude (50° N) is approximately the same as those of Vancouver (49°, 15' N) and Paris (48°, 51' N). Given the well-known effects on bone metabolism and muscle health, low vitamin D levels may negatively affect patients. Screening and treating hypovitaminosis D appears to be important in this patient population.
authors.affiliation: Department of Trauma Surgery, Justus-Liebig-University, Giessen, Germany. gerrit.s.maier@gmx.de
authors.forename: Gerrit Steffen
authors.initials: GS
authors.lastname: Maier
authors.forename: Philipp
authors.initials: P
authors.lastname: Jakobs
authors.forename: Klaus Edgar
authors.initials: KE
authors.lastname: Roth
authors.forename: Andreas Alois
authors.initials: AA
authors.lastname: Kurth
authors.forename: Uwe
authors.initials: U
authors.lastname: Maus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058872:Epidemics; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D013472:Sunlight; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*; D044465:White People
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D