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DOI: 10.1055/s-0042-1749629
Effective Vitamin D Supplementation in Patients with Tibial Fracture
Article in several languages: español | English
Abstract
Objective To determine the prevalence of vitamin D deficiency and to evaluate the safety and effectiveness of a new method of cholecalciferol loading in adult patients with a tibial fracture.
Materials and Methods We recruited 56 consecutive patients with ages ranging from 18 to 65 years with tibial fracture who were admitted to our hospital for 1 year. We determined the level of 25-hydroxyvitamin D ([25 (OH)-D]) at admission and after supplementation with a weekly dose of 100,000 IU of cholecalciferol for 3 or 5 weeks in cases of insufficiency ([25 (OH)-D] between 20 ng/mL and29.9 ng/mL) or deficiency ([25 (OH)D] < 20ng/mL) respectively. The prevalence of hypovitaminosis D, the percentage of vitamin D normalization, and the adverse effects were reported.
Results We evaluated 56 patients with tibia fractures; 98.1% presented hypovitaminosis D, and 28 (73,7%) and 10 (26,3%) showed deficit and insufficiency respectively. A total of 92.1% of the patients reached normal vitamin D levels after supplementation. No patient presented adverse effects.
Discussion The prevalence of vitamin D deficiency in our population was higher than the rates previously reported in the literature. The new vitamin D supplementation scheme proposed is safe and more effective than the one previously recommended. This supplementation scheme can be implemented in future randomized studies.
Conclusion The prevalence of hypovitaminosis D in Chilean adult patients with a tibial fracture was high (98.1%). The proposed vitamin D supplementation scheme was safe and effective.
Level of Evidence Therapeutic study. Level 2.
Publication History
Received: 15 February 2022
Accepted: 13 April 2022
Article published online:
11 July 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referencias
- 1 Gorter EA, Hamdy NAT, Appelman-Dijkstra NM, Schipper IB. The role of vitamin D in human fracture healing: a systematic review of the literature. Bone 2014; 64: 288-297
- 2 Holick MF, Vitamin D. deficiency. N Engl J Med 2007; 357 (03) 266-281
- 3 Valerio MS, Janakiram NB, Goldman SM, Dearth CL. Pleiotropic actions of Vitamin D in composite musculoskeletal trauma. Injury 2020; 51 (10) 2099-2109 [Internet]
- 4 Mesa-Ramos M, Caeiro-Rey JR, Etxebarría-Foronda I, Carpintero-Benítez P. [Aspects of interest on vitamin D for the traumatologist and orthopaedic surgeon]. Rev Esp Cir Ortop Traumatol 2012; 56 (02) 164-173 [Internet]
- 5 Holick MF, Binkley NC, Bischoff-Ferrari HA. et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96 (07) 1911-1930
- 6 Institute of Medicine. Food and Nutrition Board, Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D [Internet]. National Academies Press; 2011. 1132 p. Available from: https://books.google.com/books/about/Dietary_Reference_Intakes_for_Calcium_an.html?hl=&id=ZsMPp6I59VwC
- 7 Hilger J, Friedel A, Herr R. et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr 2014; 111 (01) 23-45 [Internet]
- 8 Le Roy C, Reyes M, González JM, Pérez-Bravo F, Castillo-Durán C. [Vitamin D nutrition in Chilean pre-school children living in extreme latitudes]. Rev Med Chil 2013; 141 (04) 435-441 [Internet]
- 9 González G, Alvarado JN, Rojas A, Navarrete C, Velásquez CG, Arteaga E. High prevalence of vitamin D deficiency in Chilean healthy postmenopausal women with normal sun exposure: additional evidence for a worldwide concern. Menopause 2007; 14 (3 Pt 1): 455-461
- 10 Rodríguez PJA, Valdivia CG, Trincado MP. Rev Med Chil 2007; 135 (01) 31-36 [Internet]
- 11 G MC. De L AD, F GM, S SI, Á VR, C AF, et al.. Niveles de vitamina D en adultos mayores saludables chilenos y su relación con desempeño funcional [Internet]. Rev Med Chil 2014; 142 (11) 1385-1391
- 12 Schweitzer D, Amenábar PP, Botello E, López M, Saavedra Y, Klaber I. Prevalencia de insuficiencia y deficiencia de vitamina D en adultos mayores con fractura de cadera en Chile. Rev Med Chil 2016; 144 (02) 175-180
- 13 Robertson DS, Jenkins T, Murtha YM. et al. Effectiveness of Vitamin D Therapy in Orthopaedic Trauma Patients. J Orthop Trauma 2015; 29 (11) e451-e453
- 14 Schwartz JB, Kane L, Bikle D. Response of Vitamin D Concentration to Vitamin D3 Administration in Older Adults without Sun Exposure: A Randomized Double-Blind Trial. J Am Geriatr Soc 2016; 64 (01) 65-72 [Internet]
- 15 Talib HJ, Ponnapakkam T, Gensure R, Cohen HW, Coupey SM. Treatment of Vitamin D Deficiency in Predominantly Hispanic and Black Adolescents: A Randomized Clinical Trial. J Pediatr 2016; 170: 266-72.e1 [Internet]
- 16 Ettehad H, Mirbolook A, Mohammadi F, Mousavi M, Ebrahimi H, Shirangi A. Changes in the serum level of vitamin d during healing of tibial and femoral shaft fractures. Trauma Mon 2014; 19 (01) e10946 [Internet]
- 17 Bodendorfer BM, Cook JL, Robertson DS. et al. Do 25-Hydroxyvitamin D Levels Correlate With Fracture Complications?. J Orthop Trauma 2016; 30 (09) e312-e317
- 18 Gorter EA, Krijnen P, Schipper IB. Vitamin D status and adult fracture healing. J Clin Orthop Trauma 2017; 8 (01) 34-37 [Internet]
- 19 Pourfeizi HH, Tabriz A, Elmi A, Aslani H. Prevalence of vitamin D deficiency and secondary hyperparathyroidism in nonunion of traumatic fractures. Acta Med Iran 2013; 51 (10) 705-710 https://www.ncbi.nlm.nih.gov/pubmed/24338144 [Internet]
- 20 Brinker MR, O'Connor DP, Monla YT, Earthman TP. Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma 2007; 21 (08) 557-570
- 21 Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P, Jones G. Vitamin D Toxicity-A Clinical Perspective. Front Endocrinol (Lausanne) 2018; 9: 550 [Internet]
- 22 Vieth R. Chapter 57 - The Pharmacology of Vitamin D. In: Feldman D, Pike JW, Adams JS. , editors. Vitamin D (Third Edition) [Internet]. San Diego: Academic Press; 2011: 1041-66 . Available from: http://www.sciencedirect.com/science/article/pii/B9780123819789100575
- 23 Cashman KD, Dowling KG, Škrabáková Z. et al. Vitamin D deficiency in Europe: pandemic?. Am J Clin Nutr 2016; 103 (04) 1033-1044
- 24 Ilahi M, Armas LAG, Heaney RP. Pharmacokinetics of a single, large dose of cholecalciferol. Am J Clin Nutr 2008; 87 (03) 688-691 [Internet]
- 25 Khaw K-T, Stewart AW, Waayer D. et al. Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial. Lancet Diabetes Endocrinol 2017; 5 (06) 438-447
- 26 Ravindra VM, Godzik J, Dailey AT. et al. Vitamin D Levels and 1-Year Fusion Outcomes in Elective Spine Surgery: A Prospective Observational Study. Spine 2015; 40 (19) 1536-1541
- 27 Eschle D, Aeschlimann AG. Is supplementation of vitamin d beneficial for fracture healing? A short review of the literature. Geriatr Orthop Surg Rehabil 2011; 2 (03) 90-93
- 28 Sprague S, Petrisor B, Scott T. et al. What Is the Role of Vitamin D Supplementation in Acute Fracture Patients? A Systematic Review and Meta-Analysis of the Prevalence of Hypovitaminosis D and Supplementation Efficacy. J Orthop Trauma 2016; 30 (02) 53-63