FRACTURES

CAUSES OF LOW VITAMIN D AND EFFECTS OF 25(OH) SUPPLEMENTATION IN PATIENTS ABOVE 50 YEARS

Abstract

To find out the effect in increase in serum 25(OH) vitamin D levels after
supplementation with 1000 IU/day of vitamin D in patients with low vitamin D levels and other
factors which may affect the increase in vitamin D levels. Study Design: Retrospective study.
Period: January 2013 and June 2014. Setting: Ch. Rehmat Ali Trust Teaching Hospital in the
Lahore. Methods: The study included patients > 50 years with a low-energy fracture and a
vitamin D level < 25 nmol/l. Results: 85 patients were included, mean basal 25(OH) vitamin D
level was 22 nmol/l. After a mean of 10 weeks, the mean increase in vitamin D was 49.5 nmol/l.
Only 45.1% reached the target level of > 50 nmol/l. The increase was correlated with the basal
level of vitamin D (p < 0.05), and the time interval between the two vitamin D measurements
(p < 0.05) and was inversely related to body weight (p < 0.05), but was not related to age,
gender or renal function. Conclusions: We found that the generally recommended dosage of
1000 IU of vitamin D per day resulted in suboptimal serum levels after ten weeks of treatment in
more than half of the patients. The increase in vitamin D levels was higher in patients with low
body weight and in patients with very low basal vitamin D levels. These data suggest that these
patients should initially be treated with higher dosages of vitamin D. If not possible, vitamin D
measurements should be performed after at least six months of supplementation with dosage
adjustment.