title: Time trend 2000-2013 of vitamin D status in older people who sustain hip fractures: steps forward or steps back? A retrospective study of 1599 patients.
abstract: BACKGROUND
  Substantial proportions of hip-fracture patients have very low serum levels of 25-hydroxyvitamin D, which can negatively affect rehabilitation. However, it is not known whether changes in vitamin D deficiency have occurred over the last years in the patients who sustain hip fractures.
  
  
  OBJECTIVE
  To assess time trend 2000-2013 of calcifediol serum levels in the hip-fracture patients admitted to our rehabilitation division.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  A rehabilitation hospital division.
  
  
  METHODS
  A number of 1599 inpatients with a hip fracture admitted between January 1, 2000 and December 31, 2013 to our rehabilitation division.
  
  
  METHODS
  A blood sample was collected in the morning following an overnight fasting 14.4±4.4 (mean±SD) days after surgery. We assessed 25-hydroxyvitamin D levels by an immunoenzymatic assay.
  
  
  RESULTS
  Calcifediol levels increased till 2006-2007 and decreased afterward. In 2006-2007, the median 25-hydroxyvitamin D level (13.1 ng/mL, interquartile range 7.9-25ng/mL) was significantly higher (P<0.001) than the one found in both the periods 2000-2001 (5.4 ng/mL, interquartile range 3.5-9 ng/mL), and 2012-2013 (7ng/mL, interquartile range 5-14 ng/mL). In the last two-year period of observation (2012-2013), 25-hydroxyvitamin D levels were slightly higher (P<0.001) than in the first one (2000-2001). The association between periods of observation and 25-hydroxyvitamin D levels persisted after adjustment for age, BMI, and sex (P<0.001).
  
  
  CONCLUSIONS
  A significant increase in calcifediol concentrations was seen till 2006-2007, but a significant decrease was observed afterward. Finally, calcifediol levels were only slightly higher in the last two years of observation than in the first two years and severe vitamin D deficiency was common during the whole 14-year study period.
  
  
  CONCLUSIONS
  Heightened awareness is needed to prevent and treat vitamin D deficiency in hip-fracture patients.
authors.affiliation: Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Turin, Italy - marco.di.monaco@alice.it.
authors.forename: Marco
authors.initials: M
authors.lastname: DI Monaco
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: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000097:blood* / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D014807:Vitamin D