Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies.

Autor: Llombart R; Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain., Mariscal G; Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain. Gonzalo.mariscal@mail.ucv.es., Barrios C; Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain., de la Rubia Ortí JE; Department of Basic Medical Sciences, Catholic University of Valencia, 46001, Valencia, Spain., Llombart-Ais R; Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.; Traumacenter, Casa de Salud Hospital, Valencia, Spain.
Jazyk: angličtina
Zdroj: Journal of endocrinological investigation [J Endocrinol Invest] 2024 Jun; Vol. 47 (6), pp. 1323-1334. Date of Electronic Publication: 2023 Dec 19.
DOI: 10.1007/s40618-023-02266-2
Abstrakt: Background: Vitamin D deficiency is common in patients with hip fractures and may negatively affect functional recovery and quality of life (QOL).
Objective: This study aimed to conduct a meta-analysis to quantify the effects of vitamin D deficiency on physical function and quality of life after hip fractures.
Methods: The PubMed, EMBASE, Scopus, and Cochrane Library databases were searched for relevant studies. The inclusion criteria were hip fracture, comparison between vitamin D deficiency and normal vitamin D levels in patients with hip fracture, and functional outcome as the primary outcome. The exclusion criteria were case reports, reviews, duplicates, studies with a high risk of bias, and non-comparable or missing data. Two independent reviewers selected studies, extracted data, assessed bias, and performed meta-analyses using the Review Manager. Heterogeneity and publication bias were also assessed. Two independent reviewers selected the studies, extracted data, and assessed the risk of bias. We performed a meta-analysis using Review Manager and assessed heterogeneity and publication bias.
Results: Seven studies with 1,972 patients were included. Vitamin D deficiency was defined as a 25(OH)D level < 20 ng/mL. There were no significant differences in the ability to walk (OR 0.68, 95% CI 0.31-1.53, I 2  = 69%) or length of hospital stay (MD 2.27 days, 95% CI - 2.47 to 7.01, I 2  = 93%) between patients with and without vitamin D deficiency. However, patients with vitamin D deficiency had significantly worse functional ability and quality of life (SMD - 1.50, 95% CI - 2.88 to - 0.12, I 2  = 96%).
Conclusions: Despite the limitations of this study, such as small sample size, heterogeneous outcome assessments, and variable vitamin D measurement techniques, the results demonstrated that screening for vitamin D status and optimizing levels through supplementation could facilitate rehabilitation, promote lifestyle changes, aid in the recovery of independence, and help reduce long-term burdens.
(© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)
Databáze: MEDLINE
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