The serum 25-hydroxyvitamin D levels and hip fracture risk: a meta-analysis of prospective cohort studies
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Qing-Bo Lv1, Xiang Gao1, Xiang Liu1, Zhen-Xuan Shao1, Qian-Hui Xu1, Li Tang1, Yong-Long Chi1 and Ai-Min Wu1
1 Department of Orthopedics, Bone Research Institute, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Second Medical School of Wenzhou Medical University, Wenzhou, Zhejiang, China
Ai-Min Wu, email:
Keywords: serum 25-hydroxyvitamin D, hip fracture, meta-analysis, dose-response
Received: December 14, 2016 Accepted: February 13, 2017 Published: March 17, 2017
Hip fracture has increasingly become a social and economic burden. The relationship between serum 25-hydroxyvitamin D levels and the risk of hip fracture reported by previous studies remains controversial. We searched Pubmed and Embase to identify studies reporting the relationship between serum 25-hydroxyvitamin D levels and risk of hip fracture. Fifteen prospective cohort studies with a total of 51239 participants and 3386 hip fracture cases were included. By pooling the Relative Risk of the lowest vs. the highest categories indicated that lower levels of serum 25-hydroxyvitamin D were more likely to be a risk factor for hip fracture with adjusted Relative Risk (95%Confidence Interval) of 1.58 (1.41, 1.77). Subgroup meta-analysis examining the stability of the primary results achieved the same results. A dose-response meta-analysis showed that the risk of hip fracture was a descending curve below the line of RR=1. The descending trend was obvious when serum 25-hydroxyvitamin D levels were less than 60 nmol/L and was flat when serum 25-hydroxyvitamin D levels were more than 60 nmol/L. We found that individuals with low levels of serum 25-hydroxyvitamin D have an increased risk of hip fracture, and this effect was evident when the serum 25-hydroxyvitamin D levels were less than 60 nmol/L.
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